Small-area estimation and prioritizing communities for obesity control in Massachusetts

Area of Science:

• Public Health
• Epidemiology
• Biostatistics

Background:

• Community-level obesity prevalence shows significant geographic and temporal variations.
• National objectives for obesity control, such as the Healthy People 2010 targets, remain challenging to meet.
• Targeted interventions are crucial for efficient resource allocation in public health initiatives.

Purpose of the Study:

• To develop and apply a novel method for assessing geographic and temporal variations in community-level obesity prevalence.
• To identify high-priority communities in Massachusetts for obesity control initiatives based on prevalence estimates.
• To understand the socio-demographic factors associated with obesity at the community level.

Main Methods:

• Small-area estimation models were developed using individual data from the Behavioral Risk Factor Surveillance System (1999-2005) and community data from the 2000 US Census.
• Obesity was defined as a body mass index (BMI) greater than or equal to 30 kg/m(2).
• A classification system, considering both the level and precision of obesity prevalence estimates, was used to designate high-priority communities.

Main Results:

• Community-level obesity prevalence estimates in Massachusetts ranged from 9% to 38% in 2005, with a consistent increase observed across all communities between 1999 and 2005.
• Less than 7% of communities achieved the Healthy People 2010 objective of obesity prevalence rates below 15%.
• Higher obesity prevalence rates were significantly associated with communities characterized by lower income levels, reduced educational attainment, and a higher proportion of blue-collar workers.

Conclusions:

• Massachusetts, mirroring national trends, faces substantial challenges in achieving national obesity control objectives.
• The application of small-area estimation models effectively identifies high-priority communities for obesity interventions.
• Targeting resources toward these identified high-priority communities is a strategic approach to maximize the impact of obesity control efforts.