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A Site Selection Web Exclusive, September 2014
WEB Exclusive story

Waistline Watch

New obesity rankings tell you if your state is one of the biggest losers.

Photo courtesy of CDC/ Debora Cartagena

Responsive Table

Early this month, the Trust for America's Health and the Robert Wood Johnson Foundation released "The State of Obesity: Better Policies for a Healthier America." It shows that adult obesity rates are still high overall, increased in six states, and did not decrease in any. Among the key findings:

  • Rates increased in the past year in Alaska, Delaware, Idaho, New Jersey, Tennessee and Wyoming. But that's better than 2005, when every state but one showed an increase.
  • Rates of obesity now exceed 35 percent for the first time in two states (Mississippi and West Virginia), are at or above 30 percent in 20 states and are not below 21 percent in any.
  • Significant geographic, income, racial, and ethnic disparities persist, with obesity rates highest in the South and among Blacks, Latinos and lower-income, less-educated Americans.

As we noted a few years ago, obesity prevalence is likely one of the least-discussed factors in site selection, for legal as well as workforce health reasons.

But increasing healthcare costs sure make it worth a chat. Among some talking points, both negative and positive:

  • The 10 states with the highest adult obesity rates are all in the South and Midwest. Yet workplace health initiatives appear to be making at least some headway in the Midwest.
  • The 10 states with the highest rates of type 2 diabetes are all in the South. So are the 10 states with the highest rates of hypertension.
  • Oregon has the highest percentage of physically active adults in the US at 83.7 percent. Colorado has the lowest obesity rate (21.3 percent) and the lowest rate of physical inactivity (17.9 percent).
  • Nearly 40 percent of American adults ages 40 to 59 are obese.

Big Data Helps Attack Problem of 'Enormous Scale'

Some might say food and beverage processors and purveyors are to blame. But a study published this week in the American Journal of Preventive Medicine somewhat absolves some of them.

Sixteen major food and beverage companies acting together as part of the Healthy Weight Commitment Foundation (HWCF) sold 6.4 trillion fewer calories in the United States in 2012 than they did in 2007, according to the study — that translates into a reduction of 78 calories per person in the United States per day. The companies in 2009 collectively pledged to remove 1 trillion calories from the marketplace by 2012, and 1.5 trillion by 2015. An independent evaluation funded by the Robert Wood Johnson Foundation found that, thus far, the companies have exceeded their 2015 pledge by more than 400 percent.

Map courtesy of Robert Wood Johnson Foundation

"Having 16 companies make individual changes that collectively cut 6.4 trillion calories is beyond impressive," said James S. Marks, MD, RWJF senior vice president. "Imagine the impact if other industry leaders stepped up to make similar — or bigger — commitments to make and market lower-calorie, healthier products for families."

A companion study found that American families with children aged 2 to 18 bought 101 fewer calories from packaged goods per person per day in 2012 than they did in 2007. The largest calorie cuts came from sweets and snacks, grain products, and carbonated soft drinks, and HWCF companies were responsible for more of the decline in caloric purchases than companies not participating in HWCF.

"HWCF companies should be recognized for stepping forward with this commitment and being held publicly accountable for their progress," said Marks. "Because of the enormous scale of the childhood obesity problem, we still need them — together with others who shape the U.S. food supply, including food and beverage manufacturers, retailers, and restaurants — to do even more to ensure that healthier choices are the easy and affordable choices for families. The real bottom line for all of us is not total calories or sales, but the health of our children."

To evaluate the HWCF's efforts, researchers at the University of North Carolina at Chapel Hill (UNC) had to build an unprecedented, thorough picture of the U.S. food system. They compiled data from many public and commercial sources that, for the first time, track the flow of foods and beverages that are sold, purchased, and consumed by Americans.

"We're now able to track how many calories families are buying, the source of those calories, and how both are changing over time," said Barry Popkin, Ph.D., the W.R. Kenan, Jr. Distinguished Professor in the School of Public Health at UNC, who is leading the evaluation team. "This new source of big data on food production and purchasing opens unprecedented opportunities to collaborate with industry leaders to find far-reaching solutions that benefit both the health of Americans and companies' bottom line."


Rank State Percentage of Adult Obesity
(Based on 2013 Data,
Including Confidence Intervals)
1 Mississippi 35.1% (+/- 1.6)
1 (tie) West Virginia 35.1% (+/- 1.5)
3 Arkansas 34.6% (+/- 1.9)
4 Tennessee 33.7% (+/- 1.8)
5 Kentucky 33.2% (+/- 1.4)
6 Louisiana 33.2% (+/- 2.1)
7 Oklahoma 32.5% (+/- 1.4)
8 Alabama 32.4% (+/- 1.7)
9 Indiana 31.8% (+/- 1.2)
10 South Carolina 31.7% (+/- 1.3)
Note: For rankings, 1 = Highest rate of obesity.
Chart courtesy of the Trust for America's Health


Rank State Percentage of Adult Physical Inactivity
(Based on 2013 Data,
Including Confidence Intervals)
Obesity Ranking
1 Mississippi 38.1% (+/- 1.7)* 1
2 Tennessee 37.2% (+/- 1.9)* 4
3 Arkansas 34.4% (+/- 1.9)* 3
4 Oklahoma 33% (+/- 1.4)* 7
5 Louisiana 32.2% (+/- 2.1) 6
6 Alabama 31.5% (+/- 1.7)* 8
7 West Virginia 31.4% (+/- 1.4) 1
8 Indiana 31% (+/- 1.2)* 9
9 Kentucky 30.2% (+/- 1.4) 5
10 Texas 30.1% (+/- 1.5)* 15
Note: For rankings, 1 = Highest rate of physical inactivity.
Chart courtesy of the Trust for America's Health


Rank State Percentage of Adult Physical Inactivity
(Based on 2013 Data,
Including Confidence Intervals)
Obesity Ranking
51 Colorado 17.9% (+/- 0.9) 51
50 Oregon 18.5% (+/- 1.5)* 36
49 D.C. 19.5% (+/-2) 49
48 Washington 20% (+/- 1.1) 32
47 Vermont 20.5% (+/- 1.3)* 44
46 Utah 20.6% (+/-1)* 46
45 California 21.4% (+/- 1.1)* 46
44 Hawaii 22.1% (+/- 1.5)* 50
43 Alaska 22.3% (+/- 1.8)* 28
42 New Hampshire 22.4% (+/- 1.5)* 35
Note: For rankings, 1 = Lowest rate of physical inactivity.
Chart courtesy of the Trust for America's Health


Rank State Percentage of Adult Obesity
(Based on 2013 Data,
Including Confidence Intervals)
51 Colorado 21.3% (+/- 0.9)
50 Hawaii 21.8% (+/- 1.4)
49 D.C. 22.9% (+/- 1.9)
48 Massachusetts 23.6% (+/- 1.1)
46 (tie) California 24.1% (+/- 1.1)
46 (tie) Utah 24.1% (+/- 1)
45 Montana 24.6% (+/- 1.2)
44 Vermont 24.7% (+/- 1.4)
43 Connecticut 25% (+/- 1.5)
42 New York 25.4% (+/- 1.2)
Note: For rankings, 1 = Lowest rate of obesity.
Chart courtesy of the Trust for America's Health

Other research — as well as Site Selection reporting on food company facility investment — has shown that, between 2007 and 2011, better-for-you, lower-calorie foods and beverages also drove financial performance for many of these same companies. Companies with a higher percentage of their sales coming from such products recorded stronger sales growth, higher operating profits, superior shareholder returns, and better company reputations. "These findings indicate growing consumer demand for healthier food and beverage products," said C. Tracy Orleans, Ph.D., RWJF senior scientist.

Here are the 16 companies committed to the HWCF calorie-reduction pledge:

  • Bumble Bee Foods, LLC
  • Campbell Soup Co.
  • ConAgra Foods (includes Ralston Foods)
  • General Mills, Inc.
  • Hillshire Brands (previously Sara Lee Corp.)
  • Kellogg Company
  • Kraft Foods Group/Mondelez
  • Mars, Inc.
  • McCormick & Company, Inc.
  • Nestlé USA
  • PepsiCo, Inc.
  • Post Foods
  • The Coca-Cola Co.
  • The Hershey Co.
  • The J.M. Smucker Co.
  • Unilever

Adam Bruns
Editor in Chief of Site Selection magazine

Adam Bruns

Adam Bruns is editor in chief and head of publications for Site Selection, and before that has served as managing editor beginning in February 2002. In the course of reporting hundreds of stories for Site Selection, Adam has visited companies and communities around the globe. A St. Louis native who grew up in the Kansas City suburbs, Adam is a 1986 alumnus of Knox College, and resided in Chicago; Midcoast Maine; Savannah, Georgia; and Lexington, Kentucky, before settling in the Greater Atlanta community of Peachtree Corners, where he lives with his wife and daughter.


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