Disparities in obesity rates: analysis by ZIP code area.

Obesity in the United States has been linked to individual income and education. Less is known about its geographic distribution. The goal of this study was to determine whether obesity rates in King County, Washington State, at the ZIP code scale were associated with area-based measures of socioeconomic status and wealth. Data from the Behavioral Risk Factor Surveillance System were analyzed. At the ZIP code scale, crude obesity rates varied six-fold. In a model adjusting for covariates and spatial dependence, property values were the strongest predictor of the area-based smoothed obesity prevalence. Geocoding of health data provides new insights into the nature of social determinants of health. Disparities in obesity rates by ZIP code area were greater than disparities associated with individual income or race/ethnicity.