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Obesity ranking of states is disputed

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A controversial report released Tuesday by a health advocacy group says Mississippi has the highest percentage of obese adults (28.1%) and Colorado the lowest (16.4%).

Trust for America's Health, a Washington, D.C.-based organization, ranked all 50 states -- except Hawaii, for which figures were not presented -- in percentage of obese adults. A person is considered obese if he is roughly 30 or more pounds over a healthy weight.

Ten states have obesity rates greater than 25%, and most of those are in the Southeast, the report says. Obesity rose in every state except Oregon, which held steady at 21%.

But government and other statistical experts take issue with the methods used to compile the ranking. The group averaged three years of data (2002-2004) from the Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System, a state-by-state telephone system in which participants report their own weight and height.

Because people are believed to underestimate weight and overestimate height, some experts say actual obesity rates are higher than data suggest in self-reported surveys of this kind.

CDC officials say the ranking is misleading for a more technical reason. "This is not a valid statistical comparison," says Michael Link, a senior survey methodologist at the agency.

The percentage of obese adults in each state actually could be several points higher or lower than the numbers indicate, Link says. Because the sample size varies from state to state, each one has a different margin of error, which means the states can't be compared without giving that range, he says.

"The bottom line is there is some difference between the top states and the bottom, but many states are almost identical in their obesity rates, so ranking them is essentially worthless from a statistical perspective."

But Shelley Hearne, executive director of Trust for America's Health, says the group consulted with government experts on the methodology. "This is the best picture we have on what's happening with our states. It's clear the southeast portion of the country has the greatest obesity numbers. Some states are further along the obesity trail than other states."

The government's National Health and Nutritional Examination Survey is considered the gold standard for assessing Americans' weight because people are actually weighed and measured. It shows that 30% of adults are considered obese and 65% are overweight or obese.

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© Copyright 2004 USA TODAY, a division of Gannett Co. Inc.

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