Social environmental factors and overweight and obesity among adolescents: Based on state-level data from 2001 to 2011

Background: Geographic clustering of unhealthy weight among adolescents may not be fully explained by individual characteristics alone. Social and physical environments vary by geography, and they may induce health behaviors related to weight outcomes. This study examines whether state-level measures of home, school, and social environments are associated with adolescent weight status.

Methods: This study uses biennial data (N=215, 2001 through 2011) from 50 US states on adolescent weight outcomes, adult health behaviors and outcomes, educational environment, food insecurity, social environment, and natural physical environment, drawn from multiple sources including the Youth Risk Behavior Survey, the Behavioral Risk Factor Surveillance System, and the US Census.

Results: The prevalence of overweight among adolescents was correlated with the percentage of obese adults (Pearson’s r = 0.59), violent crime rate (r = 0.43), National School Lunch Program (NSLP) participation rate (r = 0.38), and the percentage of households experiencing food insecurity (r = 0.35); but inversely correlated with the prevalence of adults engaging in regular physical activity (r = -0.55). The prevalence of obesity among adolescents was positively correlated with NSLP participation (r = 0.17) and household food insecurity (r = 0.14). Adolescents in states with a higher educational expenditure (r = -0.23) and higher median household income (r = -0.15) were less likely to be obese. The amount of parks and recreation space per population was not correlated with either weight status.

Conclusion: The results indicate the significance of social and environmental factors on adolescent weight status.