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Small-area estimation and prioritizing communities for obesity control in Massachusetts
Open Access Articles
  • Wenjun Li, University of Massachusetts Medical School
  • Jennifer L. Kelsey, University of Massachusetts Medical School
  • Zi Zhang
  • Stephenie C. Lemon, University of Massachusetts Medical School
  • Solomon Mezgebu
  • Cynthia Boddie-Willis
  • George W. Reed, University of Massachusetts Medical School
UMMS Affiliation
Department of Medicine, Division of Preventive and Behavorial Medicine; Department of Family Medicine and Community Health
Publication Date
Document Type
Adolescent; Adult; Aged; Aged, 80 and over; Body Mass Index; Child; Female; Humans; Male; Massachusetts; Middle Aged; Models, Statistical; Nutritional Status; Obesity; Population Surveillance; Prevalence; *Public Health; *Residence Characteristics; Risk Factors; Time Factors; Young Adult

OBJECTIVES: We developed a method to evaluate geographic and temporal variations in community-level obesity prevalence and used that method to identify communities in Massachusetts that should be considered high priority communities for obesity control.

METHODS: We developed small-area estimation models to estimate community-level obesity prevalence among community-living adults 18 years or older. Individual-level data from the Behavioral Risk Factors Surveillance System from 1999 to 2005 were integrated with community-level data from the 2000 US Census. Small-area estimation models assessed the associations of obesity (body mass index >or= 30 kg/m(2)) with individual- and community-level characteristics. A classification system based on level and precision of obesity prevalence estimates was then used to identify high-priority communities.

RESULTS: Estimates of the prevalence of community-level obesity ranged from 9% to 38% in 2005 and increased in all communities from 1999 to 2005. Fewer than 7% of communities met the Healthy People 2010 objective of prevalence rates below 15%. The highest prevalence rates occurred in communities characterized by lower income, less education, and more blue-collar workers.

CONCLUSIONS: Similar to the rest of the nation, Massachusetts faces a great challenge in reaching the national obesity control objective. Targeting high-priority communities identified by small-area estimation may maximize use of limited resources.

DOI of Published Version
Am J Public Health. 2009 Mar;99(3):511-9. Epub 2009 Jan 15. Link to article on publisher's site
Related Resources
Link to Article in PubMed
PubMed ID
Citation Information
Wenjun Li, Jennifer L. Kelsey, Zi Zhang, Stephenie C. Lemon, et al.. "Small-area estimation and prioritizing communities for obesity control in Massachusetts" Vol. 99 Iss. 3 (2009) ISSN: 0090-0036 (Linking)
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