title: The spatial distribution of gender differences in obesity prevalence differs from overall obesity prevalence among US adults.
abstract: Although obesity disparities between racial and socioeconomic groups have been well characterized, those based on gender and geography have not been as thoroughly documented. This study describes obesity prevalence by state, gender, and race and/or ethnicity to (1) characterize obesity gender inequality, (2) determine if the geographic distribution of inequality is spatially clustered, and (3) contrast the spatial clustering patterns of obesity gender inequality with overall obesity prevalence.
  
  
  
  Data from the Centers for Disease Control and Prevention's 2013 Behavioral Risk Factor Surveillance System were used to calculate state-specific obesity prevalence and gender inequality measures. Global and local Moran's indices were calculated to determine spatial autocorrelation.
  
  
  
  Age-adjusted, state-specific obesity prevalence difference and ratio measures show spatial autocorrelation (z-score = 4.89, P-value < .001). Local Moran's indices indicate the spatial distributions of obesity prevalence and obesity gender inequalities are not the same. High and low values of obesity prevalence and gender inequalities cluster in different areas of the United States.
  
  
  
  Clustering of gender inequality suggests that spatial processes operating at the state level, such as occupational or physical activity policies or social norms, are involved in the etiology of the inequality and necessitate further attention to the determinates of obesity gender inequality.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Danielle R
authors.initials: DR
authors.lastname: Gartner
authors.affiliation: Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center at Houston-Austin Regional Campus, Austin.
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Taber
authors.affiliation: Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill.
authors.forename: Jana A
authors.initials: JA
authors.lastname: Hirsch
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill. Electronic address: whitney_robinson@unc.edu.
authors.forename: Whitney R
authors.initials: WR
authors.lastname: Robinson
mesh_terms: D000328:Adult; D040343:Behavioral Risk Factor Surveillance System; D005006:Ethnicity / Q000706:statistics & numerical data; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000706:statistics & numerical data; D009765:Obesity / Q000453:epidemiology* / Q000208:ethnology; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D062206:Spatial Analysis; D014481:United States / Q000453:epidemiology
keywords: Behavioral risk factor surveillance; Continental population groups; Environment; Ethnic groups; Female; Male; Obesity; Social environment; Spatial analysis; United States