Obesity, diabetes, inactivity and the American Nations

July 27 2023

NEWPORT, R.I. – Newly published research reveals stark differences between U.S. regions in the prevalence of diabetes, obesity, and physical inactivity, as well as access to exercise opportunities, with the problems especially acute in southern regions.

The research is the result of a collaboration between Salve Regina University’s Nationhood Lab and public health researchers at the University of Illinois-Chicago and the University of Minnesota and was recently published in two peer-reviewed academic journals, Progress in Cardiovascular Disease and Current Problems in Cardiology.

In the Progress in Cardiovascular Disease paper, health scientists Ross Arena and Deepika Laddu of the University of Illinois – Chicago, the University of Minnesota’s Nicolaas Pronk, and Nationhood Lab director Colin Woodard looked at several health metrics. Using Woodard’s American Nations model of U.S. regions, the researchers found people in the Deep South and Greater Appalachia – which together comprise much of what is conventionally thought of as “the South” – were a third and a quarter more likely to report lacking physical activity than people in Yankeedom (the upper Great Lakes states and the upper tier of the northeast) or in Left Coast (the narrow Pacific coastal plain from just north of Monterrey, California to Juneau, Alaska.) The two southern regions also had higher obesity rates – 36% — compared to many other regions, which were below 30%. A similar pattern held for diabetes rates and access to exercise opportunities.

In the second paper, the researchers shared a comparison of physical inactivity rates between 2010 and 2020 revealing very small improvements in some regions, a slight worsening in El Norte (parts of the southwest first colonized by Spain), and no change at all in the Deep South. Lead author Arena – a physiologist and professor of physical therapy who specializes in the study of exercise – concluded this was “a lost decade in the battle against physical inactivity in the United States” that “should prompt significant concern amongst stakeholders from all relevant sectors .”

“The American Nations model indicates unique regional cultural differences and should be considered when crafting health promotion campaigns,” he added in the paper, published online last week at Current Problems in Cardiology and appearing in November’s print version of the journal.

The researchers recommended that regional cultural values be considered as a possible factor in crafting tailored public health messaging around healthy lifestyles.

Nationhood Lab, based at the Pell Center for International Relations and Public Policy at Salve Regina University, is an interdisciplinary research, writing, testing and dissemination project focused on counteracting the authoritarian threat to American democracy and the centrifugal forces threatening the federation’s stability. The project delivers more effective tools with which to describe and defend the American liberal democratic tradition and better understand the forces undermining it.

[This article was cross-posted from Nationhood Lab.]