Small-area estimation and prioritizing communities for obesity control in Massachusetts
Department of Medicine, Division of Preventive and Behavorial Medicine; Department of Family Medicine and Community Health
Adolescent; Adult; Aged; Aged, 80 and over; Body Mass Index; Child; Female; Humans; Male; Massachusetts; Middle Aged; Models, Statistical; Nutritional Status; Obesity; Population Surveillance; Prevalence; *Public Health; *Residence Characteristics; Risk Factors; Time Factors; Young Adult
Community Health and Preventive Medicine | Life Sciences | Medicine and Health Sciences | Public Health
OBJECTIVES: We developed a method to evaluate geographic and temporal variations in community-level obesity prevalence and used that method to identify communities in Massachusetts that should be considered high priority communities for obesity control.
METHODS: We developed small-area estimation models to estimate community-level obesity prevalence among community-living adults 18 years or older. Individual-level data from the Behavioral Risk Factors Surveillance System from 1999 to 2005 were integrated with community-level data from the 2000 US Census. Small-area estimation models assessed the associations of obesity (body mass index >or= 30 kg/m(2)) with individual- and community-level characteristics. A classification system based on level and precision of obesity prevalence estimates was then used to identify high-priority communities.
RESULTS: Estimates of the prevalence of community-level obesity ranged from 9% to 38% in 2005 and increased in all communities from 1999 to 2005. Fewer than 7% of communities met the Healthy People 2010 objective of prevalence rates below 15%. The highest prevalence rates occurred in communities characterized by lower income, less education, and more blue-collar workers.
CONCLUSIONS: Similar to the rest of the nation, Massachusetts faces a great challenge in reaching the national obesity control objective. Targeting high-priority communities identified by small-area estimation may maximize use of limited resources.
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Citation: Am J Public Health. 2009 Mar;99(3):511-9. Epub 2009 Jan 15. Link to article on publisher's site