Social and structural factors are key drivers of disparities in obesity rates

Obesity is an epidemic in the United States. It has been increasing among adults of all races and ethnicities over the last two decades; however, obesity is higher among Non-Hispanic Black adults, Hispanic adults, and American Indian or Alaska Native adults, than their White and Asian counterparts, according to the National Institutes of Health. Adults with lower income also have higher risk of obesity than those with a high income. 

A George Mason University College of Public Health team of interprofessional researchers analyzed the last five years of literature to determine how social and structural determinants of health and social injustice impact the risk of obesity, its treatment and treatment outcomes, and explored the implications for prevention and future treatment interventions. 

“We found that social determinants of health, such as where someone lives, and social inequities are primary drivers of obesity disparities,” said Michelle S. Williams, associate professor of community and global health. “Many of these determinants can be modified through interventions to reduce obesity.” 

“Population-based, equity-focused interventions that address the underlying causes of obesity disparities are needed to reduce these disparities and improve the health outcomes of minoritized and marginalized groups,” said Lawrence Cheskin, professor of nutrition and food studies. “The good news is that there are successful examples of public health interventions that communities can support to reduce obesity.” 

Successful examples include community-based interventions that focus on improving neighborhood conditions, discouraging the consumption of unhealthy foods and beverages, expanding access to obesity treatment, building safe green and play spaces, and ensuring equitable access to fruits and vegetables. 

“Even with these known successful interventions, more work needs to be done to expand and broaden programs, activities, and initiatives at the local, state, and national level in the many communities that continue to be negatively impacted by social and structural determinants of health and social injustices,” said Williams. “Public health workers can’t achieve these changes alone; policy makers must include strategies and money for these strategies in their policies at all government levels.”  

The researchers conducted a review of literature published within the last five years focused on the social and structural determinants of obesity among minoritized and marginalized adults in the United States. 

“Social and Structural Determinants of Health and Social Injustices Contributing to Obesity Disparities” was published online in Current Obesity Reports in June 2024. Sheila J. McKinney from Jackson State University is a co-author on the paper. 

Social determinants of health that affect obesity include where someone lives and their access to healthy food, access to health insurance and obesity health care, safe places to be physically active, and policies to promote health behavior.