Top Things to Know: Socioeconomic & Structural Barriers to Addressing Obesity in Communities
Published: January 15, 2026
Prepared by Josephine Harrington, MD, University of Colorado Heart and Vascular Center and Stephanie Chung, MBBS, FAHA, National Institute of Diabetes & Digestive & Kidney Disease
- Obesity rates are rising worldwide and disproportionately burden individuals from under-resourced backgrounds.
- While the causes of obesity are multi-factorial, disparities in obesity-related burden and complications are driven by social and structural factors that impact public policies, health care access, socio-economic status, health literacy, and ultimately health behaviors, such as diet, sleep, mental health, and physical activity.
- Preventing and mitigating obesity-related health disparities requires multi-pronged approaches across socio-ecological domains, including broad multi-level interventions in public policy and across health care and private sector that engage community partners and stakeholders.
- Ideally, obesity prevention in high-risk groups target upstream factors and community-wide social and structural obesogenic pathways rather than focusing solely on individual behaviors.
- Obesogenic pathways include weight-related stigmatization, economic hardship, housing and food insecurity, and limited access to neighborhood green spaces.
- Individuals living in under-resourced areas are more likely to face stress related to high crime rates, decreased access to health-promoting resources, education, transportation, safe green spaces, and healthy food options.
- Limited discretionary time is an understudied critical resource disproportionately affecting persons from lower socio-economic groups by restricting the time available for sourcing and preparing healthy foods, engaging in physical activity and adequate sleep, and accessing resources and medical care.
- Multi-pronged approaches that engage communities on a broad scale help to prevent and mitigate obesity-related disparities by promoting public policies that support equity in housing, transportation, finances, and education.
- Health care professionals are important for shaping social and culturally effective obesity management programs but need specific training on how to design systems-based holistic therapeutic plans that minimize obesity stigma, promote socially sensitive care, optimize prescribing practices, and integrate community-based lifestyle behaviors and support.
- Additional research is needed to understand the scope and scalability of effective public policies, the importance and leverage of time as a critical social determinant of health, and to identify achievable and meaningful metrics to assess the impact of these interventions.
Citation
Chung ST, Harrington J, Kandula NR, Kershaw KN, Mongraw-Chaffin M, Baah FO, Pfammatter AF, Stanton MV, Stanford FC; on behalf the American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; and Council on Quality of Care and Outcomes Research. Socioeconomic and structural barriers to addressing obesity in communities: a scientific statement from the American Heart Association. Circulation. Published online January 15, 2026. doi: 10.1161/ CIR.0000000000001395