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. 2012 Sep-Oct;18(5):402-11.
doi: 10.1097/PHH.0b013e318221718c.

Where is obesity prevention on the map?: distribution and predictors of local health department prevention activities in relation to county-level obesity prevalence in the United States

Katherine A Stamatakis  1 , Scott T Leatherdale, Christine M Marx, Yan Yan, Graham A Colditz, Ross C Brownson
Affiliations

Where is obesity prevention on the map?: distribution and predictors of local health department prevention activities in relation to county-level obesity prevalence in the United States

Katherine A Stamatakis et al. J Public Health Manag Pract. 2012 Sep-Oct.

Abstract

Context: The system of local health departments (LHDs) in the United States has the potential to advance a locally oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown.

Objective: This study examines the extent to which LHDs across the United States have responded to local levels of obesity by examining the association between jurisdiction-level obesity prevalence and the existence of obesity prevention programs.

Design: Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n = 2300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering.

Setting: Two thousand three hundred local health department jurisdictions defined with respect to county boundaries.

Participants: Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments.

Main outcome measures: Likelihood of having obesity prevention activities and association with area-level obesity prevalence.

Results: The existence of obesity prevention activities was not associated with the prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering.

Conclusions: This article identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance.

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Figures

Figure 1
Figure 1
Factors that may influence the ability of local health departments to implement evidence-based practice in obesity prevention* *Adapted from Satterfield et al., 2009
Figure 2
Figure 2
Map of local health department obesity prevention programming and county obesity prevalence, United States 2005
See this image and copyright information in PMC

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