Health With a Capital H

How Your Zip Code Can Affect Your Weight

April 8, 2014

By Omolade Alawode, Health Communications Associate 2

Yellow street sign with overweight symbols

Although it’s easy to blame fast food and sugary beverages for America’s growing obesity problem, merely scrutinizing poor eating habits gives us a limited view of a complex problem. Instead, Healthography, or the application of geographical information when studying health, shows us how interlinking community-level determinants impact an individual problem. In the case of obesity, evaluating Healthography reveals how the built environment influences access to healthy food, physical activity, and safe spaces at home, the workplace, and in the community.

The National Institute of Environmental Health Sciences (NIEHS) defines the built environment as all of the buildings, spaces, and products created or modified by people. Examples include buildings (housing, schools, workplaces); land use (industrial or residential); public resources (parks, museums); zoning regulations; and transportation systems.

Research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Agency for Healthcare Research and Quality (AHRQ) found that obesity prevalence is linked to area of residence, resources, television, walkability, land use, sprawl, and level of deprivation. In other words, when an environment is built without regard for an active lifestyle (i.e., the typical urban sprawl), the population is likely to be obese. Examples of obesogenic environmental factors include:

  • Shortage of green spaces for outdoor physical activity.
  • Lack of sidewalks and bike lanes for walking, running, and cycling.
  • Unsafe neighborhoods where residents are afraid to be active outside.
  • Fewer community centers that offer alternatives to sedentary activities like watching TV.
  • Food deserts without supermarkets, farmer’s markets, and/or corner stores.
  • Limited public transportation service areas that hinder residents’ ability to access resources.
Colorful map showing food deserts colored in orange and yello

By mapping Healthography factors, obesity can be predicted by zip code. The National Minority Quality Forum (NMQF), in collaboration with Johnson & Johnson, created the Childhood Obesity Index, an interactive map of childhood obesity prevalence in America. In the Washington, D.C. metropolitan area, zip codes in Northeast and Southeast D.C. and the surrounding Maryland suburbs have higher levels of childhood obesity (top image). Compare that map to the one generated by the U.S. Department of Agriculture’s Food Access Research Atlas, an online tool that locates food deserts. Unsurprisingly, the presence of food deserts often correlates with areas of high childhood obesity rates (bottom image).


While the built environment can aggravate conditions that cause obesity, it can also facilitate wellness through health-promoting urban development. One promising innovation is mixed-use development, a city planning scheme that blends residential, civic, and commercial spaces, including housing, community centers, supermarkets, retail stores, restaurants, and offices. By creating synergistic hubs of community activity, people live closer to where they work, shop, and play. This layout encourages active transport (e.g., walking or cycling) and use of public transportation, increases access to community resources, and provides safe places for physical activity.

The American Public Health Association (APHA) encourages public health professionals, policymakers, and members of Congress to promote inventive public health approaches and partnerships to decrease the rate of obesity, including improvements to the built environment. IQ Solutions is looking forward to gaining allies at the 2014 APHA conference in the effort to decrease the prevalence of obesity and enrich the Healthography of the built environment.

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