Disparities in Obesity Rates: Analysis by ZIP-code Area

University of Washington, Seattle, WA, USA.
Social Science & Medicine (Impact Factor: 2.89). 01/2008; 65(12):2458-63. DOI: 10.1016/j.socscimed.2007.07.001
Source: PubMed


Obesity in the United States has been linked to individual income and education. Less is known about its geographic distribution. The goal of this study was to determine whether obesity rates in King County, Washington State, at the ZIP code scale were associated with area-based measures of socioeconomic status and wealth. Data from the Behavioral Risk Factor Surveillance System were analyzed. At the ZIP code scale, crude obesity rates varied six-fold. In a model adjusting for covariates and spatial dependence, property values were the strongest predictor of the area-based smoothed obesity prevalence. Geocoding of health data provides new insights into the nature of social determinants of health. Disparities in obesity rates by ZIP code area were greater than disparities associated with individual income or race/ethnicity.

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    • "One can identify at least two subfields in the health economics literature that are related to this paper. First, a relatively large set of studies—in particular in the epidemiological and public health literature—focuses on geographical variation in health, health care, or health care expenditures as well as their determinants (Di Matteo and Di Matteo, 1998; Di Matteo, 2005; Drewnowski et al., 2007; Lahti-Koski et al., 2008; Michimi and Wimberly, 2010; Voigtländer et al., 2010; Regional Science and Urban Economics xxx (2014) xxx–xxx ☆ Peter Eibich gratefully acknowledges generous support under " BASEII " by the Bundesministerium für Bildung und Forschung (BMBF; " Federal Ministry of Education and Research " , 16SV5537). We would like to thank Adam Lederer for excellence in editing this paper. "
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    • "television viewing habits. Following previous work on economic disparities in obesity, students were asked to provide the zip code of their parents’ address as a proxy for socioeconomic status [38]. Data from the 2011 American Community Survey, collected by the US Census, were used to determine the average income for each zip code. "
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