Multilevel Analysis of Socio-Demographic Disparities in Adulthood Obesity Across the United States Geographic Regions

OBJECTIVES: The objective of this study was to examine the socio-demographic disparities in obesity among US adults across 130 metropolitan and micropolitan statistical areas. METHODS: This study used data from the 2015 Behavioral Risk Factor Surveillance System and Selected Metropolitan/Micropolitan Area Risk Trend of 159,827 US adults aged 18 years and older. Data were analyzed using the multilevel linear regression models. RESULTS: According to individual level analyses, socio-demographic disparities in obesity exist in the United States. Individuals with low socioeconomic status were associated with a higher body mass index. The participants from the Midwest United States tend to have higher body mass index than those who from the South. According to metropolitan and micropolitan statistical area level analyses, secondly, there were significant differences in obesity status between different areas and the relation of obesity with 5 socio-demographic factors varied across different areas. According to geospatial mapping analyses, even though obesity status by metropolitan and micropolitan statistical area level has improved overtime, differences in body mass index between United States regions are increasing from 2007 to 2015. CONCLUSION: Socio-demographic and regional disparities in obesity status persist among US adults. Hence, these findings underscore the need to take socio-environmental factors into account when planning obesity prevention on vulnerable populations and areas.