To fight obesity, we need healthier communities

By Daniel Weintraub

At first glance the conclusions from a recent study on obesity by the UCLA Center for Health Policy Research seem obvious: people who are overweight or obese tend to have a less healthy diet and exercise less often than people whose weight is normal.

But behind those findings is another, more compelling story:

Minorities are more likely to be obese than non-Hispanic whites.

Low-income people are more likely to be overweight than more affluent Californians.

And people with less access to affordable fresh foods and safe places to walk are more likely to be carrying extra pounds than people who have these things nearby.

Even neighborhood “cohesion” – how much you socialize with and trust your neighbors – is correlated with obesity. The more trust, the less likely a person is to be overweight.

The data are from UCLA’s most recent California Health Interview Survey, which questioned 47,000 Californians in five languages.

The information does not prove a cause and effect relationship, only that the characteristics reported in the survey were correlated with certain levels of obesity.

But it’s easy to see a connection.

In our world, eating a healthy diet and getting regular exercise can be a luxury. It’s easier to prepare fresh, healthy foods when you have time to shop and cook. And it’s easier to exercise when you have safe, convenient places to do it.

The stereotypical harried, stress-ridden business executive has nothing on the lifestyle of the typical low-income parent. For them, every day can be a struggle to earn a living, feed their kids, find quality day care and keep a car running or depend on public transportation. Home-cooked meals and a trip to the gym or a jog in a nearby park? Not so much.

The UCLA study found that people who consume one or more sodas per day or eat fast food at least twice a week are more likely to be obese than people who don’t drink soda or take regular trips to McDonald’s or Taco Bell. And frequent exercise – even walking – was found to be associated with lower rates of obesity.

The problem is that those things are also correlated with income, and income is connected to race and ethnicity. And all of these things are related to where people live.

“Neighborhoods influence what people eat and how active they are,” said Susan Babey, a UCLA professor and co-author of the study.

Babey and the study’s other author – Joelle Wolstein – offered several recommendations for addressing obesity by changing neighborhood environments:

–Increase access to fresh foods by promoting farmers markets, food co-ops and community gardens, and ensuring that more markets and co-ops accept food-subsidy vouchers available to low-income people.

–Improve perceived and actual park safety by improving lighting, providing more open areas and stepping up crime prevention efforts in those spaces.

–Improve neighborhood safety so people feel comfortable walking to and from work or the grocery store, or walking for leisure.

–Increase neighborhood social cohesion by building more opportunities for residents to interact with one another in mixed-use developments and pedestrian-oriented communities.

More than one-fourth of California adults are obese, and obesity is connected to other chronic conditions, from heart disease and diabetes to cancer. It’s a human tragedy and a drain on society’s resources – and largely preventable.

But prevention is about more than education and a stern lecture. It’s about providing the conditions that make healthy choices easier for people. Focusing on those things on the front end would be far cheaper, and more productive, than continuing to deal with the consequences of failing to act.

Note: The UCLA study was funded by The California Endowment, which is also a sponsor of The California Health Report, which Weintraub edits.

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