Obesity, or excessive body fat, is a complex condition involving the interaction of genetics, environment, and behavior. This is especially evident in Mississippi, where cultural practices, lifestyle choices, policy, and environmental factors have combined to place the state at the forefront of the national epidemic in obesity. Between 1990 and 2014 Mississippi’s adult obesity rate more than doubled, from 15 percent (the highest in the country) to 35.5 percent (third-highest). Another 35.2 percent of adult Mississippians were classified as overweight (having excessive body fat but less than obese levels). Rates are significantly higher among African Americans, among women, and among those aged twenty-six to sixty-four as well as in lower-income households.
Obesity is also a problem among Mississippi’s younger people, although signs of improvement are evident. The obesity rate for high school students fell from 18.1 percent in 2009 to 15.4 percent in 2013, while the number of overweight high school students declined from 17.7 in 2007 to 15.4 percent in 2013. Mary Currier, the state health officer, attributed the improvement to the Healthy Schools Act of 2007, which mandated healthy lunches, eliminated sugary drinks and snacks from schools, and required 150 minutes of physical activity a week for students. In addition, the obesity rate for two- to four-year-olds from low-income families dropped from 14.6 percent in 2008 to 14.9 percent in 2011.
Mississippians continue to suffer serious health conditions as a result of being overweight/obese. The adult diabetes rate has climbed from 6.9 percent in 1990 to 13.0 percent in 2014 (the second-highest rate in the country), while the adult hypertension rate rose from 28.2 percent to 40.0 percent (third-highest) over that span. Rates of obesity-related heart disease, arthritis, and cancer have also risen and are projected to continue increasing. In children, obesity not only is a harbinger of adulthood obesity and morbidity but carries current risks for metabolic, respiratory, hepatic, orthopedic, endocrine, and psychological problems, including low self-esteem and depression. Obesity places significant stress on the health care system: in 2008, the state incurred $925 million in health care costs directly related to obesity, a number that could reach an estimated $3.9 billion by 2018. Mississippi’s mortality rates from cardiovascular disease, diabetes, and stroke are among the nation’s highest, owing in part to obesity.
The role of genetics in appetite, metabolism, and other facets of obesity research is under intensive investigation. In addition, ecological factors such as nutrition knowledge, coping skills, body image, comorbid conditions, level of health literacy, overall literacy level, and self-efficacy play a role. Behavioral factors include decreased physical activity, increased sedentary activity, and decreased fruit and vegetable intake, especially associated with a high calorie/high fat diet. Family influences are crucial in the development of obesity, particularly childhood obesity, and range from food budget to dietary quality, frequency of fast-food meals, and family attitudes toward nutrition and physical activity. Other environmental factors that affect obesity within Mississippi are its levels of poverty and education, the local availability of fresh produce, the availability of recreational facilities, the ubiquitousness of fast-food and buffet-style restaurants, deeply ingrained cultural patterns, and the humid climate. Mississippi’s cultural legacy includes hospitality that often takes the form of delicious but calorie-laden cuisine, traditions that incorporate feasting, and strong feelings related to individual choices.
More than half of Mississippi’s population lives in rural areas, with a large percentage of commuters. Fast-food restaurants abound in areas with high cardiovascular mortality, often to the exclusion of grocery stores with fresh produce, thus increasing the rates of fast-food consumption as snacks before and after school or work. More than one in five Mississippians live in poverty, which has been linked to food insecurity and obesity. A lack of physical activity is associated with an increased risk of developing obesity, and in 2014 nearly a third of Mississippi adults engaged in no leisure time activity. Moreover, a 2013 study found that barely a quarter of all high school students participated in daily physical activity.
Alongside the Healthy Schools Act, Mississippi has implemented a number of additional measures to help combat its obesity problem. Since 2010 the state has participated in the Safe Routes to School National Partnership’s State Network Project, which works to encourage and increase the safety of walking and bicycling. Two years later the Move to Learn initiative began encouraging teachers across the state to lead students in short physical activity breaks, and various faith-based organizations have also implemented programs to encourage healthy eating and exercise habits. The Mississippi Grocery Access Task Force has worked since 2012 to address the lack of supermarkets and other retailers that offer healthy, affordable foods in underserved areas. And the Just Have a Ball program run by the Partnership for a Healthy Mississippi has offered thousands of elementary school students not only a playful, interactive assembly about the importance of eating healthy and remaining active but also a playground ball to take home.
In short, the national, state, and local governments are working with schools as well as community- and faith-based agencies and groups to develop innovative educational and intervention programs to help Mississippians become healthier and lower the state’s obesity rates.
- Gerri A. Cannon-Smith, “Journey to Success Preschool Obesity Prevention Pilot Program: Implications for Practice,” Poster Presentation, US Department of Health and Human Services, National Prevention Summit, Washington, D.C. (26 October 2006)
- Centers for Disease Control and Prevention, Nutrition, Physical Activity and Obesity: Data, Trends, and Maps website, https://nccd.cdc.gov/NPAO_DTM/Default.aspx
- David S. Freedman, Laura Kettel Khan, William H. Dietz, Sathanur R. Srinivasan, and Gerald S. Berenson, Pediatrics (3 September 2001)
- Siobhan C. Maty, John W. Lynch, Trivellore E. Raghunathan, and George A. Kaplan, American Journal of Public Health website, www.ajph.org (June 2008)
- “Mississippi,” Robert Wood Johnson Foundation website, http://www.rwjf.org/en/library/articles-and-news/2013/07/mississippi—signs-of-progress.html
- Mississippi Department of Health, Behavioral Risk Factor Surveillance System Report Annual Prevalence Report (2007)
- Mississippi Preventing Obesity with Every Resource (POWER) Project, Mississippi Department of Health website, www.msdh.state.ms.us
- Jerry Mitchell, Jackson Clarion-Ledger (21 September 2015)
- Astrid Newell, Amy Zlot, Kerrey Silvey, and Kiley Ariail, Preventing Chronic Disease website, www.cdc.gov/pcd/issues/2007/apr/06_0068.htm
- State of Obesity website, http://stateofobesity.org/states/ms/
- University of Mississippi Medical Center website, www.umc.edu