Paper
Introduction: Obesity and inactivity increase cardiovascular risk and are more prevalent in rural counties. The objective was to evaluate the association of county social vulnerability index (SVI) with obesity and inactivity, independent of rurality. Method: We used CDC data (2004-2019; 97.5% of 3226 US counties) on county prevalence of obesity (BMI ≥30 kg/m2) and leisure-time inactivity. CDC SVI included 4 themes (socioeconomic status, household composition & disability, minority status & language, housing type & transportation) and was scored from 0 to 1 (low to high vulnerability). We used weighted least squares regression with restricted cubic splines to model the association of SVI with obesity and inactivity (median of 2004-2019). We adjusted for sociodemographic factors and rurality and reported the partial effects of SVI with F statistics and prevalence ratios (95% CI). Result: SVI showed strong, monotonic, and independent associations with prevalence of obesity and inactivity (both, P<.001), after adjusting for sociodemographic factors and rurality. A change in SVI from the 25th to 75th percentile was associated with an 11% higher rate of obesity (1.11 [1.09-1.12]) and a 16% higher rate of inactivity (1.16 [1.14-1.18]). (Figure) Conclusion: US counties with higher SVI have higher prevalence of obesity and inactivity, independent of rurality. SVI may identify counties for targeted intervention. Disclosure B.T. Varghese: None. B. Lahr: None. A. Vella: Research Support; Novo Nordisk. Consultant; Hanmi Pharm. Co., Ltd., Crinetics Pharmaceuticals, Inc. Advisory Panel; Rezolute, Inc. M. Mielke: Consultant; Biogen. Advisory Panel; Eisai Inc., Merck & Co., Inc. Consultant; Eli Lilly and Company. Advisory Panel; Roche Diagnostics. K.R. Bailey: None. S.B. Dugani: None. Funding National Institutes of Health (K23 MD106230)