Obesity prevalence in large US cities: association with socioeconomic indicators, race/ethnicity and physical activity

Background Obesity has a complex association with socioeconomic factors. Further clarification of this association could guide population interventions. Methods To determine the relationship between obesity prevalence, socioeconomic indicators, race/ethnicity, and physical activity, we performed a cross-sectional, multivariable linear regression, with data from large US cities participating in the Big Cities Health Inventory. Results Increased household income was significantly associated with decreased obesity prevalence, for White (-1.97% per 10000USD), and Black (-3.02% per 10000USD) populations, but not Hispanic. These associations remained significant when controlling for the proportion of the population meeting physical activity guidelines. Educational attainment had a co-linear relationship with income, and only a bachelor's degree or higher was associated with a lower prevalence of obesity in White (-0.30% per percentage) and Black (-0.69% per percentage) populations. No association was found between obesity prevalence and the proportion of the population meeting physical activity guidelines for any race/ethnicity grouping. Conclusion At the population level of large US cities, obesity prevalence is inversely associated with median household income in White and Black populations. Strategies to increase socioeconomic status may also decrease obesity. Targeting attainment of physical activity guidelines as an obesity intervention needs further appraisal.

Automated summary

In large US cities, median household income is inversely correlated with obesity prevalence in White and Black populations, suggesting that increasing socioeconomic status may decrease obesity rates. However, meeting physical activity guidelines does not necessarily affect obesity prevalence.