TWO Washington cities made news in April when they found themselves on opposite top ten lists — Bellingham came in as the fourth least obese U.S. city while Yakima was pegged as the fourth most obese U.S. city.
Writing about the disparity in obesity rates between two cities separated by a mountain range and 225 miles, a Seattle Times FYI Guy blog post called the gap “peculiar.”
As two professionals working in different facets of childhood obesity prevention, we do not find this peculiar. We see it as a somewhat typical situation that demonstrates a need for community-based change.
So what is behind the tale of these two cities? While their racial and ethnic population demographics are different, the story does not end there. More telling are the other aspects of community life that are about the place.
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Not so many years ago, public-health experts speculated that where you live impacts your health status. That is no longer speculation — we now have clear evidence that employment, education, poverty, housing, discrimination and physical environment directly shape the health of a community.
In other words, your ZIP code can predict as much about your health as your genetics and ability to access health care.
Here is a recent snapshot of several key indicators in our two cities: Only 74 percent of Yakima residents graduate high school, while Bellingham boasts an impressive graduation rate at 92 percent. (Washington state on the whole is at 90 percent).
Yakima’s poverty level for families is 55 percent higher than Bellingham, with the median family income in Yakima at $46,244 while Bellingham checks in at $61,806. In the same-named county that Yakima is in, one in six households is food insecure — unable to consistently access nutritious and adequate amounts of food.
So how do these numbers translate to wildly disparate obesity rates? Education and income are two of the biggest predictors of health status. Less income puts pressure on families to purchase less expensive and more processed foods. Families in Yakima are also less likely to have the leisure time or access to safe spaces like parks and sidewalks to engage in regular physical activity.
So what are we to do? After years of skyrocketing obesity rates as a nation and a state, we are finally seeing some slowing of obesity trends, especially among our youngest children — very likely due to broad policy and system changes across many sectors of society.
The key is to build upon these initial successes. We need to ensure that assessing potential impacts on our health is a key consideration in the civic decision-making process when it comes to the issue areas that we now know influence our health outcomes. This includes transportation, education, land use, environment, parks and recreation, and, of course, health care.
In the 2014 state legislative session, Gov. Jay Inslee and our Legislature invested a modest amount of state dollars to create the “Healthiest Next Generation.” This investment marked the first time we have seen a focused state investment in health and obesity prevention.
We applaud this effort that connects prevention with education and early learning by installing staff resources at these state agencies. Continued efforts to alleviate poverty, create jobs and enable our next generation to graduate from high school and beyond would also build a healthier next generation.
Bridging gaps in obesity and health between cities and within counties requires action at all levels and in every community. Place matters.
Rebuilding our communities to make the healthy choice the easy choice for each and every citizen would level the playing field and raise the quality of life for everyone in Washington state.
Victor Colman is the director of the statewide Childhood Obesity Prevention Coalition. Lenna Liu is professor of pediatrics at University of Washington and Seattle Children’s.