Americans are fat and getting fatter by the year. Recent data reported in medical journal Lancet showed that BMI (Body Mass Index), a recognized measurement of obesity, is higher on average in America than in any other nation.
The obesity problem, however, is international. The report in Lancet states that “In 2008, 9.8 percent of the world’s male population were obese, as were 13.8 percent of women. In 1980, these rates were 4.8 percent and 7.9 percent.” US eating habits and diets have been exported, many experts say. Nations which before had relatively lean diets which were high in grains and fruits now consume many more soft drinks and hamburgers.
This trend toward poorer diets has caused obesity to be the most written-about health problem in the United States. Fat Americans are more likely to have diabetes, coronary artery disease, strokes, and certain forms of cancer. Less well reported are links between obesity and dementia, obesity and postmenopausal estrogen receptors, and obesity and social status. Thin people, apparently, are more likely to be chief executives and billionaires. The problem of obesity is so acute that the number of studies about its causes and solutions grows by the day. The journal Health Affairs reported last year that overall obesity-related health spending reaches $147 billion in the US, about double what it was a decade earlier.
Like so many other issues where data is collected in the public sector and the information is used to solve problems nationwide, the problems are local. 24/7 Wall St. looked at a number of factors which cause unhealthy diets and resulting obesity. These include income, access to healthy food sources, the ability to pay for healthy food, the concentration of fast food outlets, and the consumption of fruits, vegetables, sugar, fat, and soft drinks. The levels of healthy eating defined with these parameters varies wildly from state-to-state. That means there is not likely to be any one set of solutions created and funded at the federal level to solve the problem. Just as education results and their causes are hyper-local, so are the habits that cause unhealthy diets and their results. That makes the problem harder to solve. Congress cannot mandate how many McDonald’s can be built within any hundred square mile area, or, if it could, McDonald’s would object.
The data on poor eating habits and obesity are abundant and unusually well-researched. Congress funded a nationwide report which was called “Access to Affordable and Nutritious Food – Measuring and Understanding Food Deserts And Their Consequences.” The information contained in this report includes the number of households who do not have access to cars and probably find it difficult to go to grocery stores frequently. The USDA keeps in-depth statistics on concentration of grocery stores. The Census Bureau tracks fast food expenditures per capita. The US Department of Health and Human Services follows consumption of fruits and vegetables. 24/7 made its state rankings based on grocery stores per 1000 residents, amount spent on fast food per capita, gallons of soft drinks purchased per capita, and pounds of sweet snacks purchased per capita. We also took into account information provided about poverty levels, obesity, and other factors directly related to unhealthy diets.
It is worth mentioning again how complex and local the obesity and eating habit problem is. This does not mean that the problems are insoluble, but nearly so. The issue of fat Americans is one that almost needs to be addressed house-to-house.
10. New Mexico
> Grocery Stores Per 1000 Residents: 0.26 (23rd)
> Amount Spent on Fast Food Per Capita: $737 (8th most)
> Gallons of Soft Drinks Purchased Per Capita: 58 (12th least)
> Pounds of Sweet Snacks Purchased Per Capita: 111 (13th least)
New Mexico’s worst rankings occur in two metrics. It has the 44th greatest percentage of households without a car that are more than ten miles from a supermarket or grocery store and the 44th greatest percentage of population that has low income and is more than ten miles from a supermarket or grocery store, according to the United States Department of Agriculture. These metrics are significant because they suggest a lack of access to affordable and nutritious food. Residents may rely on fast food restaurants and convenience stores instead. New Mexico has the eighth greatest amount of money spent on fast food per capita among all the states considered.
> Grocery Stores Per 1000 Residents: 0.17 (47th)
> Amount Spent on Fast Food Per Capita: $761 (fourth most)
> Gallons of Soft Drinks Purchased Per Capita: 60 (21st least)
> Pounds of Sweet Snacks Purchased Per Capita: 109 (11th least)
Arizona has the second fewest of grocery stores per person, with only 0.177 for every 1,000 people. This illustrates a major restriction on healthy food access for one of the country’s fastest growing states. One of the ways in which residents of Arizona are supplementing their diets is with fast food. Arizonans spent an average of $760.50 each on fast food in 2007, the fourth greatest amount among the states.
Click the Image for a Larger Graph of Adult Diabetes Rates by State.
> Grocery Stores Per 1000 Residents: 0.18 (45th)
> Amount Spent on Fast Food Per Capita: $622 (20th least)
> Gallons of Soft Drinks Purchased Per Capita: 70 (11th most)
> Pounds of Sweet Snacks Purchased Per Capita: 122 (10th most)
Because a large part of Ohio’s poor population is located in major urban centers like Cleveland and Cincinnati, the state ranks well in regards to access to grocery stores among the poor. However, the state ranks third-worst in store availability across all income classes at 0.18 locations per 1000 people, compared to 0.6 in first place North Dakota. Ohio’s population has the eleventh-greatest consumption of soft drinks, and the ninth-highest consumption of both sweet snacks and solid fats. As a result of these poor diets, Ohio has an adult diabetes occurrence of over 10%, which is the eleventh worst rate in the country.
7. South Dakota
> Grocery Stores Per 1000 Residents: 0.5 (4th)
> Amount Spent on Fast Food Per Capita: $547 (9th least)
> Gallons of Soft Drinks Purchased Per Capita: 64 (23rd least)
> Pounds of Sweet Snacks Purchased Per Capita: 122 (8th most)
South Dakota is the fifth smallest population in the country, and yet, it is the 17th largest state in terms of geographic area. As a result, many residents have limited access to affordable and nutritious food. In fact, South Dakota has the greatest percentage of households with no car and which are more than ten miles from a supermarket or grocery store, as well as the greatest percentage of low-income households which are more than ten miles from a supermarket or grocery store. Only 10.1% of adults in South Dakota consume the U.S. Department of Health and Human Services’ recommended 2 or more fruits and 3 or more vegetables per day, compared to the national average of 14%. This is the fifth worst rate in the nation.
Click Image to See Large Graph of Adult Obesity
> Grocery Stores Per 1000 Residents: 0.23 (29th)
> Amount Spent on Fast Food Per Capita: $939 (most)
> Gallons of Soft Drinks Purchased Per Capita: 58 (10th least)
> Pounds of Sweet Snacks Purchased Per Capita: 114 (19th least)
Nevada spends the most per capita on fast food – nearly $940 per person per year. This is roughly 25% more than Texas, the second worst state, and well more than twice what Vermont residents spend. As might be expected, the state ranks in the bottom ten for both households with no cars’ and low-income populations’, defined as people with income less than 200 percent of the Federal poverty thresholds, and proximity to grocery stores. Nevada’s obesity and diabetes rates, are above average.
> Grocery Stores Per 1000 Residents: 0.25 (24th)
> Amount Spent on Fast Food Per Capita: $676 (15th most)
> Gallons of Soft Drinks Purchased Per Capita: 69.8 (8th most)
> Pounds of Sweet Snacks Purchased Per Capita: 103.2 (third least)
The rate of household-level food insecurity, including households with food access problems as well as households that experience disruptions in their food intake patterns due to inadequate resources for food, is 15.2% in Oklahoma. The national rate is 13.5%. Oklahoma also has the third lowest rate of adults who meet the recommended two fruit/three vegetable daily intake, with only 9.3% of adults doing so. Perhaps this is part of the reason Oklahoma’s obesity rate is 31.4%, the fifth worst in the country.
> Grocery Stores Per 1000 Residents: 0.35 (7th)
> Amount Spent on Fast Food Per Capita: $610 (19th least)
> Gallons of Soft Drinks Purchased Per Capita: 64 (23rd most)
> Pounds of Sweet Snacks Purchased Per Capita: 121 (12th most)
Kansas has some of the easiest access (seventh-best) to stores where cheap and healthy food is available. It is clear, however, that most residents do not take advantage of this, as the state has one of the worst diets in the country. Residents consume the twelfth most sweet snacks per person as well as the twelfth most solid fats – more than twenty pounds per person. The state ranks 28th in adult diabetes and 31st in obesity – 28% of the state’s adults are considered overweight.
> Grocery Stores Per 1000 Residents: 0.26 (22nd)
> Amount Spent on Fast Food Per Capita: $623 (21st least)
> Gallons of Soft Drinks Purchased Per Capita: 65 (18th highest)
> Pounds of Sweet Snacks Purchased Per Capita: 121 (17th most)
Missouri does not rank especially poor in any of the metrics considered, however it does rank badly in about almost every one. It has the 11th lowest rates of adults eating the recommended amount of fruits and vegetables, the eighth greatest rate of food insecurity, and relatively high rates of soft drink, sweet snack, and solid fats consumption. Missouri has the 9th worst rate of obesity among adults, with 30% having a body mass index greater than 30.
Click Image to See Larger Graph of Fast Food Expenditures Per Capita
> Grocery Stores Per 1000 Residents: 0.21 (37th)
> Amount Spent on Fast Food Per Capita: $649 (23rd most)
> Gallons of Soft Drinks Purchased Per Capita: 77 (fourth most)
> Pounds of Sweet Snacks Purchased Per Capita: 113 (16th least)
Alabama residents consume 77 gallons of soft drinks per capita per year, the fourth highest amount in the country. This is roughly 33% more than Oregon, which consumes the least. Soft drinks like cola have more sugar per ounce than nearly any other food we regularly consume, and it is clear that soda has helped contribute to Alabama’s poor health outcomes. The state has the seventh highest obesity rate and, predictably, the second worst diabetes rate. More than 12% of the state’s adult population has the disease.
> Grocery Stores Per 1000 Residents: 0.21 (34th)
> Amount Spent on Fast Food Per Capita: $588 (17th least)
> Gallons of Soft Drinks Purchased Per Capita: 82 (most)
> Pounds of Sweet Snacks Purchased Per Capita: 113 (17th least)
Mississippi has the worst eating habits in the country. Only 8.8% of the adult population eats the recommended amount of daily fruits and vegetables, the lowest rate in the country. Residents consumed just under 82 gallons of soft drinks per capita in 2006, the greatest amount reported. Furthermore, the state has the third highest rate of household-level food insecurity, with 17.1% of households being effected. It is perhaps unsurprising, then, that the state has the highest rates of both adult diabetes (12.8%) and adult obesity (34.4%).
-Charles B. Stockdale, Douglas A. McIntyre and Michael B. Sauter
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