Obesity and Diabetes (in the wild)
Also be sure to check out this very nice figure which shows the United States at the county level by rate of diabetes and obesity. It’s really striking in this figure just how centralized high levels of obesity are in the southeast and Appalachia. It also show the close relationship between high levels of obesity with a large prevalence of diabetes.
There are two other pockets that strike me as interesting: Northeastern Arizona and the border of North and South Dakota. What explains those high levels of obesity and diabetes? The first thing that comes to mind is that those could possibly be areas with a large population of Native Americans. So I Googled “Native American’s and obesity” and I found this study: “The epidemic of obesity in American Indian communities and the need for childhood obesity-prevention programs.” The first few sentences of the abstract are: “American Indians of all ages and both sexes have a high prevalence of obesity. The high prevalence of diabetes mellitus in American Indians shows the adverse effects that obesity has in these communities. Obesity has become a major health problem in American Indians only in the past 1–2 generations and is believed to be associated with the relative abundance of high-fat foods and the rapid change from active to sedentary lifestyles. Intervention studies are urgently needed in American Indian communities to develop and test effective strategies for weight reduction.”
And this study: “Prevalence of Obesity Among US Preschool Children in Different Racial and Ethnic Groups” (Sarah E. Anderson, PhD; Robert C. Whitaker, MD, MPH. Arch Pediatr Adolesc Med. 2009;163(4):344-348.) which claims these results: “Results Obesity prevalence among 4-year-old US children (mean age, 52.3 months) was 18.4% (95% confidence interval [CI], 17.1%-19.8%). Obesity prevalence differed by racial/ethnic group (P < .001): American Indian/Native Alaskan, 31.2% (95% CI, 24.6%-37.8%); Hispanic, 22.0% (95% CI, 19.5%-24.5%); non-Hispanic black, 20.8% (95% CI, 17.8%-23.7%); non-Hispanic white, 15.9% (95% CI, 14.3%-17.5%); and Asian, 12.8% (95% CI, 10.0%-15.6%). All pairwise differences in obesity prevalence between racial/ethnic groups were statistically significant after a Bonferroni adjustment (P < .005) except for those between Hispanic and non-Hispanic black children and between non-Hispanic white and Asian children."