AUTHOR=Allen Jeffrey 

TITLE=The indirect effects of food insecurity on obesogenic environments

JOURNAL=Frontiers in Public Health

VOLUME=Volume 10 - 2022

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.1052957

DOI=10.3389/fpubh.2022.1052957

ISSN=2296-2565

ABSTRACT=Introduction:  The Centers for Disease Control and Prevention (CDC) estimates 39.8 % of United States (US) residents are obese (Centers for Disease Control and Prevention (CDC), 2018). This study examined obesity-related factors at the county-level to determine the indirect effects on physical inactivity, insufficient sleep duration, income inequality, food insecurity, on obesity rates. 
Methodology:  Using the 2018 Robert Wood Johnson Foundation (RWJF) County Health Rankings data set, a multiple regression analysis was conducted to measure the percentage of the obesity rate explained by physical inactivity, insufficient sleep duration, food insecurity, and income inequality. The indirect relationships between obesity-related variables and obesity were measured and illustrated through a path analysis model. 
Results:  This study found the combination of independent variables explained 53% of the obesity rates in the US, R2 = .53, p < .001, two-tailed. This study also found that food insecurity has both a direct and indirect effect on obesity, physical inactivity, and insufficient sleep duration. Physical inactivity has a direct and indirect effect on obesity and a direct effect on insufficient sleep duration. Insufficient sleep duration has a direct effect on obesity. 
Conclusion:  This analysis found that food insecurity indirectly impacts an obesogenic environment and drives county-level BMI averages. The dataset used for analysis predates the COVID-19 pandemic but presents the effect of food insecurity during a normative year. The findings, though interesting, provide an opportunity for future research.
Keywords:  food insecurity, obesity, physical inactivity, insufficient sleep, public health, health inequities