There’s some controversy over whether fighting obesity should begin with the person or the place where he or she lives. In a new study, lead author Dr. Michael Halpern, associate professor in the department of health services administration and policy at Temple University College of Public Health, argues that addressing the needs of individuals is more effective than tackling problems facing a community or neighborhood as a whole.
The study, using data from the Community Transformation Grant Program and funded by the U.S. Centers for Disease Control and Prevention, and published in the new journal Health Equity, found that a person’s sociodemographic characteristics are much better predictors of being overweight or obese than the makeup of their community. In order to develop meaningful interventions to fight obesity, then, the research suggests that developing programs tailored toward individuals is more effective than addressing the needs of an entire neighborhood.
For years, research and schools of thought on this topic have been divided. Many approaches, such as the focus on food deserts over the past few years, have operated at community levels. The findings from Dr. Halpern and his colleagues, however, represent a strong push toward the individual argument.
“We know that with other kinds of health behaviors there’s never a one-size-fits-all approach,” said Dr. Halpern. “Something like smoking cessation has to be tailored to the individual: What are the motivating factors, what will work for them?”
This study, he says, puts fighting obesity in the same camp: “You can’t go in and say, ‘This is the problem in the community, and we can address it with one program.’ Everyone is unique. We need to recognize that and provide assistance to the individual.”
To determine this, Dr. Halpern and his colleagues surveyed 21,531 people from 35 rural and urban areas across the country for their perception of the food environments in their community and in their home. That’s measuring, respectively, if they thought fruits and vegetables were available to them, and if they bought those items. Then, researchers compared that information with objective factors including each subject’s body mass index (BMI) and their proximity to grocery stores.
The data revealed a partial disconnect: People’s perceptions of their community food environment matched their perceptions of their home food environment. In other words, those who said they could buy fruits and vegetables in their neighborhood also perceived their home food environment as healthy. But, a perceived healthy home food environment did not predict lower BMI. Similarly, the presence or absence of grocery stores did not correlate with obesity or overweight statistics.
By contrast, individual factors such as a participant’s race or ethnicity, age, education and household income were consistently much better predictors of a subject being overweight or obese.
“We saw significant differences by age, race and ethnicity and education that, I think, reflect differences in culture, experience and general nutrition patterns,” said Dr. Halpern. “Interventions need to be tailored toward what the individuals can do in their environment and what they’re likely to do given their culture and context.”