Wenjun Li ^1*, Jennifer L. Kelsey ¹, Zi Zhang ², Stephenie C. Lemon ¹, Solomon Mezgebu ², Cynthia Boddie-Willis ², George W. Reed ¹

¹ University of Massachusetts Medical School
² Massachusetts Department of Public Health

^* To whom correspondence should be addressed. E-mail: wenjun.li{at}umassmed.edu.

	Abstract

Objectives. We identified high-priority communities for obesity control efforts in Massachusetts.

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 index30 kg/m²) 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.

Key Words: Geography, Obesity, Overweight, Underweight, Public Health Practice, Surveillance, Surveys, Statistics/Evaluation/Research