Do national numbers inaccurately represent Washington, DC’s obesity condition? what electronic and personal health records can do to help

It’s easy to see that the characterization of District of Columbia as “one of the skinniest states” may not be accurate. You just need to look at a map. I’ll discuss how I got here below the images.

Adult Obesity Prevalence by Ward, Source: 2007 District of Columbia Behavioral Risk Factor Surveillance System (DC BRFSS); Washington DC First Ever Obesity Report*

Prevalence of Physically Active Adults by Ward, Source: 2007 District of Columbia Behavioral Risk Factor Surveillance System (DC BRFSS); Washington DC First Ever Obesity Report

For a little orientation, Ward 1 includes Adams Morgan, Columbia Heights, and Mount Pleasant. Ward 2 is where the White House and center of the Federal Government is; it includes Dupont Circle, and Georgetown. Ward 3 includes, Tenleytown, Friendship Heights, and Chevy Chase. I live on the border of Ward1 and Ward 2 (and it’s gorgeous, by the way, as are all the Wards). Ward 8 includes Anacostia. I’ve never been there.

The median household income of Ward 3 is $71.875. The median household income of ward 8 is $25,017, 33% of its residents live below the poverty line.

DC Ward 7 and 8 have higher obesity rates than the most obese state in the union (Mississippi). They resemble West Virginia more than they resemble Colorado.

My glass-half-full nature and love of Washington, DC are fairly apparent (it’s my 3 year DC-versary in a week…) and one of the pieces of information I’ve mentioned here several times is our apparent low obesity rate -we rank third lowest in the nation.

Here’s a list of just a few data sources that characterize DC as “one of the skinniest” states. I’ve done it, too.

The problem with the data is that it hides the real problem.

While people may criticize social media for leading people astray from the facts, this time it provided information to look beyond the press releases.

My first indication that something wasn’t right was in this post, where I published a nice data visualization from JESS3, which showed a relatively low obesity rate (from the national data above) with a high poverty and food insecurity rate. I called this a “paradox,” looking at the diagram, but actually it’s not a paradox. Something’s not right in Washington, DC, and the graphic points to it, indirectly. I didn’t figure it out at the time of the post, but I did think something could be wrong…..

Another post in August on the WeLoveDC blog led to a comprehensive look at DC’s obesity situation, the Washington, DC Obesity Report and Action Plan (the first ever), and the facts are contained within, as well as information about physical activity (in the map above), access to healthy food, recreation facilities and the like.

If you’ve read this far to read about the connection to Electronic Health Records and Personal Health Records, I’ve decided to break this topic up into two blog posts, so I’ll write about that in my next post. In the meantime, feel free to reflect on the data and what the national pronouncements mean next to the information; see if you agree that many of us didn’t understand the information correctly. Thanks for Web 2.0 for making sure the conversation never ends.

*Note, I looked and did not see any copyright notices on the Washington, DC report, so I am assuming these images are public record, if they aren’t, anyone reading this can let me know.


A great post, as usual!

The maps you present and your mention of the data hiding the problem gave me a weird idea. What would it take to run the Pew survey about chronic diseases and Internet uses across each of the DC wards? Do you think that you'ld find correlation between what you know about obesity rates, median household income, internet use, broadband access, rate of chronic diseases prevalence and finally PAM levels?

Maybe Susannah could give a little feedback.

Funny you should ask, Gilles!

Last spring I gave a presentation at a OneWebDay event on Capitol Hill, talking about the Pew Internet Project's national broadband data:

If you watch the video clip on that page, you'll see I start by thanking a fellow panelist, Kenneth Boley, Director of Intergovernmental Initiatives in DC's Office of Chief Technology Officer. He had just presented a mash-up of DC's demographic data and Pew Internet's broadband data, then showed how that picture matched with local internet providers' estimates of ward by ward broadband penetration. It was such a proud data geek moment for me – Pew Internet's open, freely published data used by a government official to inform policy decisions that affect my city.

I would welcome a mash-up of our data and local DC data. Caveat: I don't have the time to do it myself, but that is the beauty of open data — all of our survey data is published on our site:

Problem with Obesity? What Problem? I Don't Have No Stinking Problem!

Check out the recent Harris Poll data that shows where obese individuals, including morbidly obese folks, do not perceive themselves as being as large "as they really are." Even more interesting is the finding that 2/3's of obese folks reportedly have never have been told by their physicians that they have a problem with weight! My latest post is on this very subject. Check it out.


My bet is that people are too busy too much time on Twitter, etc. to take the time to exercise.

Steve Wilkins

Mind the Gap


Dear Steve,

Great timing on your excellent post – I didn't know about the Harris Data or the 61% figure – you'll see that the story I tell in today's post directly relates to it – thank you!

Dear Gilles,

Certainly! And maybe similarly to how the plan has mapped out distance to parks and groceries, there could be a companion "distance to an internet connection", with this version including connections to friends and family who have internet access, distance to libraries, mobile use/access it, etc. This study, as well as this article from the Washington Post last year, point to the need for a different kind of assessment for these populations.

Keep the ideas coming,



I think it's not just the distance to Internet access. It's also, and now maybe more importantly, what you do once you have Internet access. Susannah and myself have been writing about this from different perspectives over the last 2 weeks at I think for example that although mobile is now king ans making everybody gain access to the Internet this access is not without a deep impact on what kind of interactions people will have with health related resources. You can generalize about the impact of various methods of Internet access and how they force UI differences and therefore individual experiences with different online resources. So, I fully agree with you we must think of different kinds of assessments for different populations.

Ted Eytan, MD