Getting a Handle on the Social Environment for Obesity

The idea that obesity is contagious is a “brilliant analogy,” says a distinguished professor of pediatrics, Leonard Epstein. More and more research supports this view. But the ideas about contagion require careful thinking in this context. Thinking about transmitting obesity from one person to another is not especially helpful. What’s more relevant is thinking about the social environment. And a new study in Social Science and Medicine uses sophisticated spatial analysis techniques to add more insight.

Obesity Prevalence That Spreads Across a Region

Massimiliano Agovino and colleagues use Spatial Markov Chains to look for geographic proximity effects in obesity rates. Are regional patterns in obesity – such as we see in the southern states – more than mere coincidence? And indeed they are.

Proximity effects, say these researchers, play an important role in the way that obesity spreads through clusters of nearby states. Obesity rates in an adjacent state can make a very real difference in they way that another state’s obesity rates change over time. Southern U.S. states “may suffer from a perverse ‘geographical lock-in’ effect that calls for coordinated action,” they say.

Taking a Broader View of the Food Environment

It’s easy enough to see the environment for physical activity in terms of a geographic context. Much research documents the importance of the built environment for routine physical activity levels.

However, when people think about the “toxic food environment” contributing to obesity, much of that thinking typically focuses upon the food itself. What is the composition of macronutrients? How much sugar, salt, and fat? Is it ultra-processed? Does it have “supernormal appetitive properties“?

But perhaps we should pay more attention to cultural factors that influence eating behaviors. Media and food marketing play a role. However, they are only a part of the larger food culture. It’s not hard to see that expectations for how you will feed yourself are different in the deep south or New Orleans than they are in Manhattan or Seattle. Likewise, the food culture of north central states like Wisconsin is very distinct. And obesity rates are high.

Understanding these factors and how to reshape them will not be easy. But without a deeper understanding of shared cultural environments, coping with the social transmission of obesity will be even harder.

Click here for the study by Agovino et al. You can find more relevant research and commentary here, here, here, and here.

Sharing a Snack, photograph © Andy Morffew / flickr

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November 30, 2018