Tipping the Scales

Southwestern Pennsylvania has the highest percentage of “healthy weight” adults among the Pittsburgh Today benchmark regions, according to 2016 data from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, the most recent available.

But here’s the catch: Fewer than 1 in 3 southwestern Pennsylvanians are a healthy weight and more than 1 in 3 are obese.

Austin has the smallest percentage of obese adults among the benchmark regions with 32.9 percent, while the seven county Pittsburgh Metropolitan Statistical Area ranked at the benchmark average of 35 percent. In Cincinnati, 37.9 percent of the population reported an obese weight—the highest among benchmark regions.

A healthy weight is defined as having a body mass index (BMI) between 18.5 and 25. An obese BMI is 30 or higher.

Having a comparatively higher rate of healthy weight adults while still having a large share of the population at an obese weight suggest possible socio-economic disparities are at play in the region, according to Bernard Goldstein, professor emeritus, Environmental and Occupational Health at the University of Pittsburgh.

“What it suggests is that there is a very susceptible population in terms of weight gain,” said Goldstein. “It’s a reverse socio-economic thing. The thinner you are the more likely you are to belong to a higher socio-economic group.”

Public health crisis

The rate of overweight or obese Americans is a national public health crisis that is increasingly evident among children. Childhood overweight rates in the U.S. increased from 29 percent to 35 percent from 1999 to 2016, according to a recent study in Pediatrics that looked at data from the Centers for Disease Control and Prevention’s National Health and Nutrition Examination Survey.

Nationally, childhood obesity rates have been steady over the past four years, but have increased in certain socio-economic groups. Children from low-income families had twice the obesity rate than children in middle-income families.

Reducing obesity is a complex challenge involving behavioral change and other factors. Poverty broadens the challenge.

“There’s an environmental justice issue,” said Noble Maseru, professor, Behavioral and Community Health Sciences and director of Center for Health Equity at the University of Pittsburgh. “We’ve identified the amenities that are necessary for healthy community—things like safe bike and walking paths, parks, walkable, affordable and quality supermarkets. Food deserts still exist.”

National public health campaigns include former First Lady Michelle Obama’s Let’s Move, which revamped exercise programs in underserved schools, and the U.S. Department of Agriculture’s Healthy, Hunger-Free Kids Act, which attempts to make school lunches healthier. Cities such as Seattle and Philadelphia have levied a tax on sugary drinks. In Allegheny County, the Live Well Allegheny campaign provides incentives to groups for promoting nutrition and physical activity and expands partnerships with local health and wellness organizations.

“At the core, it’s about changing people’s behavior,” said Maseru. “And for change, at some point, there has to be aggressive leadership from all the domains—schools, government, managed care, even insurance companies.”