(PORTLAND TRIBUNE) — Portlanders living in close-in neighborhoods are more likely to have trimmer figures and physiques.
People in outlaying neighborhoods — and many suburbs — are more likely to sport love handles, beer bellies and other extra pounds.
Those are some of the early findings from health researchers’ effort to track Oregon’s growing obesity problem, by using driver’s license data to compile the Body Mass Index of adults throughout the state. Mapping the data enables researchers to track patterns and pinpoint problems down to the neighborhood or even block level.
You might call it new food for thought.
Analysts can drill down into the data to assess whether public policies such as bike paths, bus routes and healthier school lunches can stem the rising tide of obesity that threatens to cut short many Portlanders’ lives, including a whole generation of children.
“Obesity prevention is a top priority in public health these days, and up until now we only had data at the county level,” says Daniel Morris, a former state epidemiologist who spearheaded the driver’s license project.
Much like entry-level drugs and alcohol, being overweight can be a gateway to more severe problems such as diabetes, heart attacks, strokes, a poorer quality of life and shorter lifespan.
The Coalition for a Livable Future used the driver’s license data from Morris’ project to create a series of interactive maps, enabling researchers and policy analysts to try to correlate pockets of overweight people with other factors such as ethnicity, income, and access to parks, fresh and healthy food, and transit.
One clear pattern emerged that everyone expected: People with higher incomes and more education are more likely to have their weight in a healthier range, while those with lower incomes and less schooling are more prone to being overweight and obese.
“I think the patterns are really striking, how strong the associations are between BMI and the indicators of socioeconomic status,” Morris says.
Others found a strong affirmation for what the city of Portland calls “20-minute neighborhoods,” generally closer-in areas where residents can walk or bike easily to fill most of their essential needs.
“It suggests a strong correlation between the ability to have a healthy weight and factors in our community: access to transit, healthy food, parks, walkable neighborhoods, etc.,” says Mara Gross, executive director of the Coalition for a Livable Future. “Maps are a good way to visualize data,” Gross says. “Maps help to make things understandable.”
“I think the most striking thing about the map is the consistency and the pattern that it shows that the lowest BMI tends to be closer to the urban core of the region,” says
Kris Smock, project manager for the coalition’s mapping project, known as the Regional Equity Atlas 2.0.
Residents of affluent areas such as Laurelhurst, Mount Tabor, and Irvington have lower average BMIs, the maps show. Those in working-class neighborhoods such as Brentwood-Darlington, Lents, Centennial and Hazelwood are heavier on average, and those are areas where the city hopes to develop more 20-minute neighborhoods.
The same pattern plays out in the suburbs, with Lake Oswego and West Linn showing lower average weights, in contrast to those in blue-collar cities such as Milwaukie and Gresham.
But could some of the disparities be because of, say, the lack of good bus service in East Portland? Or more time spent in cars for residents of Sherwood and Oregon City, who tend to have higher BMIs?
“People who take a bus have an average of a 10-minute walk on either side of that,” says Michelle Kunec-North, a program coordinator at the Portland
Bureau of Planning and Sustainability, who is evaluating health factors for the city’s rewrite of its comprehensive plan. That means people taking a bus get an average of 20 minutes’ exercise per weekday that those driving to work don’t get.
“Every hour in a day you spend in a car, your obesity risk goes up 6 percent,” Morris says.
Do communities like Cornelius and Fairview score on the heavy side because of their income levels? Or can some of that be traced to their high Hispanic population, whose ethnic diet is rich in tortillas and lard?
Researchers can now probe for answers to such questions by overlaying the maps in the new Regional Equity Atlas 2.0, released in June.
Bonnie Nicholas noticed her weight grew slowly but steadily over 20 years, partly because she was just going out and enjoying Portland’s restaurants, food carts and live music.
The other night she went to dinner with her sweetie and consumed half a bottle of wine. She went out another weeknight to hear music and drank some more.
“It adds up,” she says. “Food carts may be yummy, but that doesn’t mean they’re all good for you.”
But Nicholas, 51, realized all that extra weight was making her more tired and even sore. “I’d wake up in the morning and my ribs hurt,” she says.
After joining Weight Watchers three years ago, she lost 25 pounds in six months, and has managed to keep off all but two pounds of it.
Nicholas rides her bike five and a half miles most days from her home in Northeast Portland’s Woodlawn neighborhood to her job downtown. A habitual “grazer” during the day, she learned to stock fresh fruit to nibble on at her desk. And she’s learned some other tricks. “I like having a smaller plate, because you fill up your plate when you’re cooking at home.”
When she goes to her favorite sandwich shop, she shares one with a friend. That way, there’s “no overeating,” she says, “and both get a bargain.”
She advises others facing weight problems to start with simple changes, like taking their daily cups of coffee without sugar.
Jerry Rhodes, who handles communications for CareOregon, also is trying to lose weight through Weight Watchers. He says it’s critical for parents to encourage their children to play outside more. And Rhodes cautions against relying too much on Body Mass Index to gauge a person’s health. “BMI is a bogus measure,” he says, because it doesn’t take into account differences in body type. A football player can have very little body fat but register a high BMI, he says.
How they did it
Health researchers caution that BMI isn’t a perfect way to evaluate a healthy weight, and stress that the new maps are a simplified measure of the obesity problem. They can only illustrate things associated with an average weight level in an area, not the causes, says Betsy Clapp, research analyst with Multnomah County Health Department.
The maps show averages, anyway, and everyone is unique. A variety of factors contribute to obesity, including genes, income, ethnicity, education level, habits and factors in their community and lifestyle.
But the maps are the best available data right now. And Oregon is the first state in the nation to publish statewide BMI maps, Morris says.
Body Mass Index is a ratio based on a person’s weight and height. A rough standard set by the World Health Organization in 1995 deemed a BMI higher than 25 as overweight, and a BMI higher than 30 as obese.
The map numbers also have to be taken with a grain of salt because many peoples’ weights reflected on their driver’s licenses are no longer accurate — or never were. Studies show that women under-report their weight at the Department of Motor Vehicles by 5 percent on average, and men under-report it by 2 percent on average, Morris says.
Researchers did not adjust the data in the maps to reflect that, though, because what they hope to show is patterns.
No individual’s personal data is being released, and the public won’t be able to examine data for a tiny area, such as a block with five residents, for fear someone could glean an individual’s data from that.
Initial review of the maps appears to confirm that what the public health sector calls “healthy eating, active living” seems to correlate with better BMIs.
Multnomah County research shows that parts of North Portland, not East Portland, are the areas of the city with the least access to fresh and healthy food. Interestingly, the St. Johns and Kenton neighborhoods also scored high on the BMI maps, despite undergoing gentrification in recent years.
Researchers hope to explore patterns showing BMI levels one wouldn’t ordinarily expect, much as a low-income school with high test scores can provide useful insights for educational improvements.
“It can be a real ‘aha’ moment, and can open up the conversation to more people, more solutions,” says Noelle Dobson, associate director of the nonprofit Oregon Public Health Institute.
Morris found it interesting that the Salem area had higher than expected BMI. Perhaps one factor is the large number of state office workers with sedentary jobs, he speculates.
The Coalition for a Livable Future released an initial Regional Equity Atlas in 2007, which focused more on features in the built environment such as parks. That was used by Metro, Gross says, to prioritize areas lacking in natural areas when it awarded Nature in Neighborhoods grants.
The new atlas adds a whole new layer of health data, such as on asthma and BMI.
Clapp is using it to work with the nonprofit Verde on planning for the Cully Park redevelopment in Northeast Portland. The Oregon Public Health Institute is using the data, in tandem with Ecumenical Ministries of Oregon, on a food access initiative in the Rockwood neighborhood in Gresham.
To check out the new maps, and download free software to analyze them, log on to clfuture.org/programs/regional-equity-atlas/equity-atlas-20-mapping-tool