Obesity is tied not to states, per se, but to certain populations who reside in those states, says Barbara Ormond, senior research associate at the Health Policy Center of the Urban Institute, a Washington, D.C.-based think tank. Each of these populations grapple with specific problems, she explains. "Take, for example, comfort food, she says, which varies by culture and nutritional quality.
According to the CDC, non-Hispanic blacks have the highest rates of obesity, followed by Mexican Americans, all Hispanics, and non-Hispanic whites. When it comes to socioeconomic status, the data differ by gender. For example, college-educated women and women who earn higher incomes are less likely to be obese than women who didn't graduate high school or earn lower salaries. However, such correlations don't exist among men, for whom obesity is roughly the same across income levels. In fact, higher incomes were associated with increased obesity rates among non-Hispanic black and Mexican-American men, the CDC reports.
Such complexities explain Ormond's caveat against labeling obesity a poverty problem. It's a "shorthand way of looking at it" that reduces it almost to something that's hard to do anything about, she says. "You can't make everybody not poor, but you could give them good schools, or you could make sure the school lunch you're serving is nutritious."
Fixing this problem is going to take a proverbial village, public health experts say.
"We need to mobilize all sectors of society," Blumenthal says, calling for policies that will create more places to walk and exercise, as well as physical and health education in schools and healthier choices in vending machines, for example. But communities can begin the intervention, she says, noting the Affordable Care Act's Prevention and Public Health Fund, which can seed local efforts. Neighborhoods might come together to organize a health fair, coordinate a race to motivate community weight loss, or plant community gardens, she advises.
And beyond that, those working to fight obesity in this country ought to be patient and persistent, Ormond says. "It took us many, many years to get as fat as we are as a nation, and it's going to take us a similar number of years, or certainly a lot of effort to reverse that trend."