• Ross Arena, Nicolaas P Pronk, and Colin Woodard.
• Department of Physical Therapy, College of Applied Science, University of Illinois, Chicago, IL; Healthy Living for Pandemic Event Protection (HL - PIVOT) Network, Chicago, IL. Electronic address: raarena@uic.edu.
• Am. J. Med. 2024 Mar 1; 137 (3): 240248240-248.

BackgroundPhysical inactivity and obesity crises persist in the United States despite substantial mitigation efforts. The primary goal of this analysis is to determine whether the geographic concentration of religious institutions overlaps with geographic patterns for physical inactivity and obesity prevalence.MethodsWe obtained 2021 county-level, age-adjusted physical inactivity ("no leisure time physical activity") and obesity prevalence from the 2023 Centers for Disease Control and Prevention PLACES database. Data on number of congregations per 100,000 individuals and adherents as a percentage of the population were obtained from the 2020 US Religion Census. The American Nations regional cultures model was obtained from the Nationhood Lab.ResultsOn a national level, all correlations were statistically significant between health factors and religious infrastructure-higher physical inactivity and obesity were related to more congregations per 100,000 population on a county level. The strength of correlations between congregations per 100,000 county population and both physical inactivity and obesity prevalence was greatest in the American Nations model's Deep South and Tidewater regions.ConclusionsApproaches to addressing the pandemics of unhealthy lifestyle-related health factors of physical inactivity and obesity in the United States have, in large part, been unsuccessful. Church-based healthy lifestyle programs, particularly in areas where a high concentration of congregations align with high physical inactivity and obesity, may offer a novel and effective approach to addressing this issue.Copyright © 2023 Elsevier Inc. All rights reserved.

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