Format

Send to

Choose Destination
J Public Health Manag Pract. 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.

Author information

1
Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri 63110, USA. stamatakisk@wustl.edu

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.

PMID:
22836530
PMCID:
PMC3711616
DOI:
10.1097/PHH.0b013e318221718c
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Wolters Kluwer Icon for PubMed Central
Loading ...
Support Center