Geographic Association Between Income Inequality and Obesity Among Adults in New York State

INTRODUCTION: In addition to economic factors and geographic area poverty, area income inequality — the extent to which income is distributed in an uneven manner across a population — has been found to influence health outcomes and obesity. We used a spatial-based approach to describe interactions between neighboring areas with the objective of generating new insights into the relationships between county-level income inequality, poverty, and obesity prevalence across New York State (NYS). METHODS: We used data from the 2015 American Community Survey and 2013 obesity estimates from the Centers for Disease Control and Prevention for NYS to examine correlations between county-level economic factors and obesity. Spatial mapping and analysis were conducted with ArcMap. Ordinary least squares modeling with adjusting variables was used to examine associations between county-level obesity percentages and county-level income inequality (Gini index). Univariate spatial analysis was conducted between obesity and Gini index, and globally weighted regression and Hot Spot Analysis were used to view spatial clustering. RESULTS: Although higher income inequality was associated with lower obesity rates, a higher percentage of poverty was associated with higher obesity rates. A higher percentage of Hispanic population was associated with lower obesity rates. When tested spatially, higher income inequality was associated with a greater decrease in obesity in southern and eastern NYS counties than in the northern and western counties, with some differences by sex present in this association. CONCLUSION: Increased income inequality and lower poverty percentage were significantly linked to lower obesity rates across NYS counties for men. Income inequality influence differed by geographic location. These findings indicate that in areas with high income inequality, currently unknown aspects of the environment may benefit low-income residents. Future studies should also include environmental factors possibly linked to obesity.