Selection of Populations at Highest Risk and Strategies for Intervention
The results of state and national surveys show that obesity rates far exceed the Healthy People 2010 objective of 5 percent across the population. Furthermore, the prevalence of overweight and obesity has increased for all Americans and New Yorkers. Thus, broad strategies affecting all New Yorkers and all socio-ecological spheres are needed.
Although the problem is pandemic, there are population groups at even greater risk. Findings from 2003, based on self-report, show that the prevalence of obesity in adults increases with age, and is inversely associated with income and educational attainment. Obesity prevalence among adults exceeds 25 percent for those with less than a high school education, a household income less that $15,000 annually, and those 45-64 years of age. Over one-third (36.5%) of New York State adults with disabilities are obese.
There are also disparities in obesity rates by racial/ethnic groups and by gender. Over two-thirds (67.4%) of non-Hispanic Black adults in New York State are overweight or obese, compared to 58.3% Hispanics and 55.0% White non-Hispanics. Obesity prevalence among non-Hispanic Black adults (29.9%) is 1.5 times that of non-Hispanic Whites (20.1%). Non-Hispanic Black females are at particularly high risk with an obesity rate of 32.9%, compared to 25.6% for Hispanic females and 18.1% for non-Hispanic Whites.
Thus, high-risk populations in New York State include children, especially Hispanic children. Adults with low-education and low-income are also at increased risk of obesity and black women are an especially high risk subgroup. Challenges to reaching these high-risk populations will involve understanding perceptions of the public health risks associated with obesity, identifying barriers, and developing culturally and linguistically appropriate messages. Furthermore, overcoming barriers of low-income populations such as unsafe neighborhoods, limiting outside play and physical activity, may require changes to ordinances, capital improvement programs, and other planning practices by state and local government. Strategies aimed at businesses to increase accessibility and affordability of more healthful foods may require innovative incentives.