Obesity rises in nearly all counties but Americans becoming more physically active

More people are running, biking, and exercising in other ways in hundreds of US counties, according to new research from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

The rise in levels will have a positive on Americans by reducing death and chronic disability from cardiovascular diseases and diabetes. But the trend has had little impact so far on stopping the of . As physical activity increased between 2001 and 2009, so did the percentage of the population considered obese. Obesity and risk factors from poor diets, smoking, and all are causing a drag on US life expectancies, which increased slowly compared to the country's economic peers between 1985 and 2010.

"Around the country, you can see huge increases in the percentage of people becoming physically active, which research tells us is certain to have benefits," said IHME Director Dr. Christopher Murray, "If communities in the US can replicate this success and tackle the ongoing obesity impact, it will see more substantial health gains."

These results were published July 10 in the open-access, peer-reviewed journal Population Health Metrics in two studies—"Left Behind: Widening Disparities for Males and Females in US County Life Expectancy, 1985-2010" and "Prevalence of Physical Activity and Obesity in US Counties 2001-2011: A Road Map for Action." The findings will be presented by Dr. Murray today to city and county officials at an event hosted by First Lady Michelle Obama as part of her Let's Move! campaign.

Counties in Kentucky, Georgia, and Florida all reported big gains in physical activity. The highest increase for was in Concho County, Texas, up from 41.4% in 2001 to 58.2% in 2009, and women in Morgan County, Kentucky, increased from 25.7% to 44%. For the study, sufficient physical activity was defined as 150 total minutes of per week or 75 minutes of .

By this definition, which counties were the most and least active for men in 2011?

Most active:

Teton, WY 77.5%
Summit, UT 73.2%
Routt, CO 72.9%
Summit, CO 72.7%
Jefferson, WA 72.2%
Nevada, CA 71.9%
La Plata, CO 71.9%
Wasatch, UT 71.7%
Kauai, HI 71.6%
Los Alamos, NM 71.4%

Least active:

Owsley, KY 33.1%
Holmes, OH 33.7%
Wolfe, KY 34.2%
Issaquena, MS 34.6%
McDowell, WV 34.7%
Casey, KY 34.8%
Clay, KY 35.8%
Mingo, WV 36.0%
Clinton, KY 36.1%
Taliaferro, GA 36.4%

Which counties were the most active and least active for women in 2011?

Most active:

Routt, CO 74.7%
Marin, CA 74.2%
Teton, WY 72.7%
Pitkin, CO 72.4%
San Juan, WA 71.6%
Summit, UT 69.6%
Eagle, CO 69.6%
Barnstable, MA 69.2%
Benton, OR 69.1%
Rio Blanco, CO 68.8%

Least active:

Issaquena, MS 28.4%
Noxubee, MS 29%
Quitman, MS 29.1%
Tallahatchie, MS 30.7%
Haywood, TN 30.7%
Tunica, MS 30.7%
McDowell, WV 30.8%
Humphreys, MS 30.9%
East Carroll, LA 31.2%
Taliaferro, GA 31.3%

The highest increase in obesity for men was in Lewis County, Kentucky, which jumped from 28.9% in 2001 to 44.7% in 2009. For women in Berkeley County, South Carolina, obesity rates increased from 36.1% in 2001 to 47.9% in 2009.

Which counties had the lowest and highest percentages of obesity in men in 2011?

Lowest:

San Francisco, CA 18.3%
New York, NY 19.1%
Falls Church City, VA 19.5%
Santa Fe, NM 21%
Pitkin, CO 21.3%
Teton, WY 21.6%
Eagle, CO 22%
Fairfax City, VA 22%
District of Columbia 22.4%
Summit, UT 22.4%

Highest:

Owsley, KY 46.9%
Issaquena, MS 46.7%
East Carroll, LA 46.6%
Holmes, OH 46.4%
Starr, TX 46.2%
Lewis, KY 46.1%
McDowell, WV 46%
Lincoln, WV 45.9%
Allen, LA 45.6%
Union, FL 45.5%

Which counties had the lowest and highest percentages of obesity in women in 2011?

Lowest:

Falls Church City, VA 17.6%
Pitkin, CO 18.5%
Douglas, CO 18.6%
Routt, CO 19%
Teton, WY 19.6%
Summit, UT 20%
San Francisco, CA 20.9%
Eagle, CO 20.9%
Marin, CA 21.1%
Gallatin, MT 21.9%

Highest:

Issaquena, MS 59.3%
Humphreys, MS 59.1%
East Carroll, LA 58.9%
Quitman, MS 58.1%
Greene, AL 58%
Allendale, SC 58%
Wilcox, AL 57.8%
Shannon, SD 57.7%
Jefferson, MS 57.7%
Holmes, MS 57.6%

"More aggressive strategies to prevent and control obesity are needed. Diet and changes in individual behavior are key components," said Dr. Ali Mokdad, Professor of Global Health at IHME and a coauthor of both studies. "Understanding local trends in obesity and physical activity in both rural and urban areas will help communities develop successful strategies and learn from one another."

Because of the increase in obesity over the last two decades, high body mass index (BMI) is now the third-leading risk factor to health, according to "The State of US Health, 1990-2010: Burden of Diseases, Injuries, and Risk Factors"—another IHME study published today, in the Journal of the American Medical Association. The toll posed by obesity was also cited in another new IHME study, on .

The highest life expectancy for men increased from 75.5 years in 1985 to 81.7 years in 2010, and the lowest life expectancy remained under 65, which ranks below Indonesia. For women at the county level, the highest life expectancy increased from 81.1 years in 1985 to 85 years in 2010, and lowest life expectancy remained at about 73 years, lower than Botswana.

"That's slow progress in life expectancy compared to other countries around the world, and it's especially slow for women," said Dr. Haidong Wang, Assistant Professor of Global Health at IHME and lead author on the life expectancy study.

In 1,405 counties in the US, there was no significant change in life expectancy for women in a quarter century. The same was true in 154 counties for men. Women in Marin County, California, live the longest at 85 years, better than Spain and France. Women in Perry County, Kentucky, have the shortest average life expectancy at 72.7 years, which puts them behind their peers in Russia and Vietnam. Men in Fairfax County, Virginia, live longer than men in Japan and Switzerland at 81.7 years, but men in McDowell County, West Virginia, fare worse than men in Yemen and Sudan as they live to 63.9 years on average.

Where did men have the longest and the shortest life expectancies at birth in 2010?

Longest (in years):

Fairfax County, VA 81.67
Gunnison, CO 81.65
Pitkin, CO 81.65
Montgomery, MD 81.57
Marin, CA 81.44
Douglas, CO 81.41
Eagle, CO 81.01
Loudoun, VA 81
Santa Clara, CA 80.98
Teton, WY 80.93

Shortest (in years):

McDowell, WV 63.9
Bolivar, MS 65.03
Perry, KY 66.52
Floyd, KY 66.59
Tunica, MS 66.7
Quitman, MS 66.7
Sunflower, MS 66.92
Coahoma, MS 66.92
Washington, MS 67.1
Macon, AL 67.19

Where did women have the longest and the shortest life expectancies at birth in 2010?

Longest (in years):

Marin, CA 85.02
Montgomery, MD 84.87
Collier, FL 84.62
Santa Clara, CA 84.54
Fairfax County, VA 84.52
San Francisco, CA 84.38
Gunnison, CO 84.33
Pitkin, CO 84.33
San Mateo, CA 84.3
Bergen, NJ 84.26

Shortest (in years):

Perry, KY 72.65
McDowell, WV 72.9
Tunica, MS 73.36
Quitman, MS 73.36
Petersburg, VA 73.69
Sunflower, MS 73.85
Mississippi, AR 73.85
Mingo, WV 73.92
Washington, MS 74.09
Leslie, KY 74.12

"While lack of access to health care and poor quality health care are important factors behind life expectancy, community factors that support healthy eating and active living are also vitally important to health and well-being," said Dr. David Fleming, Director and Health Officer for Public Health – Seattle & King County. "The health system across the US has a critical role to play in community prevention efforts that will help people live longer and healthier lives."

More information: Detailed findings by county are available for download and in data visualization tools at: www.healthmetricsandevaluation … zation/us-health-map

To explore the trends for the United States in depth, go to our Global Burden of Disease visualization page and search for the US in any of IHME's tools: www.healthmetricsandevaluation … sualizations/country

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