Obesity, Race/Ethnicity, and COVID-19

Obesity is a common, serious, and costly chronic disease. Having obesity puts people at risk for many other serious chronic diseases and increases the risk of severe illness from COVID-19. Everyone has a role to play in turning the tide against obesity and its disproportionate impact on racial and ethnic minority groups.

Adult Obesity is Increasing

                                                      2019 Adult Obesity Prevalence Maps

The 2019 CDC Adult Obesity Prevalence Maps¹ show that obesity remains high – twelve states now have an adult obesity prevalence at or above 35 percent: Alabama, Arkansas, Indiana, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Oklahoma, South Carolina, Tennessee, and West Virginia. This is up from nine states in 2018.

Obesity Worsens Outcomes from COVID-19

Adults with excess weight are at even greater risk during the COVID-19 pandemic:

• Having obesity increases the risk of severe illness from COVID-19. People who are overweight may also be at increased risk.
• Having obesity may triple the risk of hospitalization due to a COVID-19 infection.
• Obesity is linked to impaired immune function.^2,3
• Obesity decreases lung capacity and reserve and can make ventilation more difficult.⁴
• As BMI increases, the risk of death from COVID-19 increases.⁵
• Studies have demonstrated that obesity may be linked to lower vaccine responses for numerous diseases (influenza⁶, Hepatitis B^7,8,9, tetanus¹⁰).

Obesity Disproportionately Impacts Some Racial and Ethnic Minority Groups

Combined data from 2017-2019 show notable racial and ethnic disparities:

• Non-Hispanic Black adults had the highest prevalence of self-reported obesity (39.8%), followed by Hispanic adults (33.8%), and non-Hispanic White adults (29.9%).
• 6 states had an obesity prevalence of 35 percent or higher among non-Hispanic White adults.
• 15 states had an obesity prevalence of 35 percent or higher among Hispanic adults.
• 34 states and the District of Columbia (D.C.) had an obesity prevalence of 35 percent or higher among non-Hispanic Black adults.

Hispanic and non-Hispanic Black adults have a higher prevalence of obesity and are more likely to suffer worse outcomes from COVID-19.  Racial and ethnic minority groups have historically not had broad opportunities for economic, physical, and emotional health, and these inequities have increased the risk of getting sick and dying from COVID-19 for some groups.  Many of these same factors are contributing to the higher level of obesity in some racial and ethnic minority groups.

What Can be Done

Obesity is a complex disease with many contributing factors. Neighborhood design, access to healthy, affordable foods and beverages, and access to safe and convenient places for physical activity can all impact obesity.  The racial and ethnic disparities in obesity underscore the need to address social determinants of health such as poverty, education, and housing to remove barriers to health. This will take action at the policy and systems level to ensure that obesity prevention and management starts early, and that everyone has access to good nutrition and safe places to be physically active. Policy makers and community leaders must work to ensure that their communities, environments, and systems support a healthy, active lifestyle for all.