Over the past decade, obesity has emerged as the single greatest public health concern in the US. Between 2002 and 2012, the percentage of adults classified as obese (BMI 30kg/Sq m or more) has risen from 26% to nearly 40%. This figure is up from only 14% in 1980. Poor diets, an increasingly sedentary lifestyle, and lack of physical exercise have all contributed to growing waistlines in the US.
The consequences of this growing obesity problem have been substantial for the US healthcare system, as obesity is linked with many health problems including heart disease, diabetes, cancer, stroke and liver disease. In fact, the Centers for Disease Control and Prevention estimate that annual obesity-related medical costs in the US are nearly US$150 billion. These rapidly rising healthcare expenditures have led to the coining of the phrase “obesity crisis,” and consumer awareness of this issue has been growing. Government action, like First Lady Michelle Obama’s “Let’s Move” campaign, has aimed to educate children and their families on the importance of good nutrition and exercise to maintain a healthy weight. Television shows like “The Biggest Loser” and “Jamie Oliver’s Food Revolution” have also made a healthy diet and physical activity mainstream ideas. Healthcare practitioners have also been working to inform their patients about the health benefits of losing weight.
Strong Regional Variations
While obesity remains a key public health issue across the country, there are clear regional variations in the magnitude of the problem. Obesity is a greater problem in the Southern and Midwestern states than in Northeastern or Western states. Among all regions, the South struggles most with obesity, as nine states in the region reported obesity rates over 31% in 2012. The region was also home to the seven states with the highest obesity rates in 2012, including Louisiana (34.7%), Mississippi (34.6%), Arkansas (34.5%), West Virginia (33.8%), and Alabama (33.0%).
Prevalence of Self-Reported Obesity by State, 2012
As a result of these high obesity rates, the South has seen a dramatic increase in some of the health problems associated with obesity. A November 2012 report issued by the Centers for Disease Control, for instance, found that the prevalence of diabetes in the South increased dramatically between 1995 and 2010, with the strongest increases coming in states like Oklahoma (+226%), Kentucky (+158%), Georgia (+145%), and Alabama (+140%).
This presents a few vital questions. Has increased awareness of the obesity crisis resulted in behavioral change in the states that need it most? Have consumers in Southern states altered their eating habits in the face of such a severe obesity crisis?
An Evolving Diet
There is indeed evidence that Southern consumption patterns are changing. From 2007-2012, per capita spending in the South on categories many consider “junk foods” have grown more slowly than the national average. This is especially true in sweet and savoury snacks, where per capita spending grew 5 percentage points slower than the US average, and in biscuits (cookies and crackers), where per capita spending in the South actually declined despite US growth during the same period.
Source: Euromonitor International
In addition to cutting spending on “junk foods,” consumers in the South are also spending less on oils and fats than in the past. Many traditional Southern dishes – including fried chicken, cornbread, grits, biscuits, and butter beans – are prepared with large volumes of butter, margarine, or oil and maintain a high fat content. However, since 2007, per capita spending in the South on oils and fats grew more than 4 points slower than the US average as consumers in the region look to cook and eat healthier.
These health-focused habits are also evident in sales of soft drinks. The South, which stands as the historical birthplace of Coca-Cola, Pepsi, and Dr. Pepper, has a very strong association with carbonates. In fact, were it an independent country, the South would rank as the world’s largest carbonates market in terms of total volume sales. However, interest groups have been able to generate a close association between carbonates and the US obesity crisis in recent years. As a result, volume sales of carbonates in the US have been on the decline, and the South has led this charge with per capita volume sales falling more steeply than in any other region. In place of carbonates, health-focused Southern consumers have been switching to no-calorie beverages like bottled water, which witnessed per capita volume sales growth was three times faster than the US average since 2007.