Obesity remains a critical impediment to black health, the Boston Public Health Commission (BPHC) revealed in its latest “Health of Boston” report.
The disease disproportionately affects blacks —32 percent of black adults are obese, compared to just 17 percent in whites. Roxbury, Dorchester and Mattapan are also the three neighborhoods with the highest obesity rates.
While in other races, obesity is inversely related to income — so a higher income means a lower percentage of obesity — in blacks, rates remain constant regardless of socio-economic status. Instead, obesity is more closely related to education — blacks who attended some college have a 26 percent rate, compared to 41 percent for those without a high school diploma.
Obesity also hits women harder than men, with 40 percent of black women carrying the disease compared to 23 percent of men.
The BPHC’s data reveal that obesity begins early in life. Similar to adult rates, 32 percent of black public high school students are obese, ranking at the top of all racial groups. Teenage girls also suffer higher rates than teenage boys.
Because obesity is related to diet and exercise, it is unsurprising that blacks rank poorly in these health indicators as well. Only 26 percent of black adults consume the recommended five servings of fruits and vegetables each day — the lowest of all racial groups. And among black public high school students, only 17 percent fulfill these nutritional guidelines. At the same time, 82 percent of these students drink soda every day — so more teens fill up on sugar than fresh foods.
Black students report the highest levels of exercise, but these rates still remain low — only 29 percent engage in regular physical activity. More students watch television and play video games than exercise. More than half of students — 53 percent — watch an excess of three hours of television on school nights, and nearly a third play computer or video games for the same amount of time.
As the report explained, “Sedentary behaviors such as TV watching and playing electronic video or computer games are associated with obesity in both children and adults.”
Adult exercise rates are substantially higher, at 52 percent.
Obesity has serious health consequences, the report showed. Blacks top rates of heart disease, high blood pressure, high cholesterol and diabetes — all diseases related to obesity. Heart disease is the second leading cause of death for black residents, after cancer — and for all Bostonians. But blacks, along with Latinos, have the highest hospitalization and mortality rates for heart disease. Prevention, according to the BPHC, includes “maintaining a healthy weight and eating nutritious food.”
Thirty-seven percent of obese adults and 27 percent of overweight adults have high blood pressure. Similarly, 31 percent of obese adults and 30 percent of overweight adults, have high cholesterol. Both of these rates stands high above city averages, indicating that maintaining a higher weight than normal puts a person at serious risk for these conditions.
Overweight and obesity can also lead to diabetes. Eighteen percent of overweight and obese adults suffer from diabetes — high above the citywide average of 6 percent. While affecting a relatively small number of people, diabetes is one of the leading causes of black deaths in Boston, and one of the fastest-growing medical conditions. In the past 10 years, the black diabetes rate increased 50 percent, and remains the highest of all racial groups in the city.
Moreover, diabetes in children is on the rise. The BPHC explained: “Recent evidence demonstrates that about four out of ten new diabetes patients are being identified among children, mainly as the result of obesity and lack of regular physical exercise and chronic disease or disability. ”
While the BPHC acknowledges that individual choices, such as diet and exercise, contribute to the growing obesity epidemic, it also recognizes the structural forces at play, including lack of access to fresh foods and little physical education at schools.
“To be effective in bringing about community change,” the report explains, “approaches which recognize that health behaviors are shaped by one’s social, economic, and neighborhood context must be developed.”
“The Health of Boston,” a report issued annually since 1996, offers the city’s latest health statistics. The full report can be downloaded at www.bphc.org <http://www.bphc.org