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The Obesity Epidemic: A Tale of Two Cities

February 12, 2015

Two Washington cities -- Bellingham and Yakima -- find themselves at opposite ends of the nation's obesity scale. There is no single factor that determines obesity rates, so why have these two cities experienced such different results?


Bellingham, the northernmost city in the contiguous U.S., is also at the top in other ways. It’s one of Washington’s most scenic cities, sharing seaport charm and mountain traditions. A university town, it’s called one of America’s best places to retire.

It’s also one of America’s healthiest, thinnest and most active cities, ranking fourth among U.S. cities with the lowest obesity rates. Bellingham's obesity rate is 18.7% (having a body mass index (BMI) of 30 or over is considered obese).

“Bellingham tends to do really well in comparison to other places in terms of health indicators, health factors,” according to Whatcom County Community Health Manager Dr. Astrid Newell. “It’s a place that tends to embrace an active lifestyle, healthy food—those are parts of our community.”

There is no single factor that determines obesity rates, but Bellingham has a lot going for it in terms of how it’s keeping its obesity rate low.

First of all, fitness and exercise are obvious facets of Bellingham’s culture. There is a high number of fitness professionals in the city’s population, and the availability of recreational amenities (such as bike-friendly roads, hiking trails, urban walkability and parks) are well-used, with 60% of residents getting regular exercise.

Gil Lund keeps in shape by working out on his skate skis near Bellingham Bay on a cold wintry day.

“You have the bay, you have mountains, you have hiking trails, parks and community trails,” says Newell. “The natural environment really provides opportunities for people to be outside and active.”

The Lund family, lifelong residents of Bellingham, typify the city's healthy picture. Gil is a runner and skier, and gets ready for the slopes by ski skating next to the bay, even on soggy winter days. Spouse Kim and daughter Campbell can be found in regular yoga classes, and Campbell is an avid lacrosse player.  The Lund family's garage looks like a sports shop, with racks of skis, snowboards and other exercise equipment. Young son Gunnar has plenty to choose from for nearby Mt. Baker's snow season.

Access to ample, nutritious food is a big determinant in healthy weight, and Bellingham has a thriving farm-to-table food culture. The city has a vibrant weekly farmer's market. Fresh and locally-sourced ingredients are readily available not just at the local markets, but also on residents’ doorsteps—CSA (Community Supported Agriculture) services deliver boxes of fresh produce and foodstuffs directly to subscribers.  The Lunds plan nutirious and fresh meals from  the ingredients of the weekly box. 

Food access, however, isn’t just determined by proximity to markets or the availability of CSA services. It’s also a function of income, and Bellingham’s median family income is right up there at almost $62,000 a year.

“Income is proxy for what you have access to and from the stresses in your life,”  suggests Newell. “Can you buy produce and other health options with your budget?”

The Lund family, of Bellingham, looks over the week’s CSA produce delivery.

The city is also well-educated, with a high school graduation rate of 92%, and 39% of residents having a college degree—well above the state as a whole. With the presence of Western Washington University, Bellingham’s obesity rates may be driven down by the school’s 15,000+ students (people under 25 tend to be less obese), but it’s still clear that educational attainment is another contributor to overall community health.

Another factor? Bellingham’s ethnic makeup. The city is 84 percent Caucasian.

“Native-American, Hispanic, [and] Blacks tend to have higher rates of obesity than Caucasian populations,” says Newell. “But if you break that down, is that really because of the race-ethnicity, or is it because of the stressors and higher rates of poverty that are within those communities?”

Perhaps the answer to that question can be found when comparing Bellingham to the city of Yakima, just a few hours’ drive away.


Located in the heart of central Washington, agriculture drives the economy in Yakima—the ninth most populated city in the state.

An iconic billboard there promotes the area as “The Palm Springs of Washington.” But when it comes to the health of the community, the conditions in Yakima and Yakima County are far from sunny.

Yakima has found itself on the other side of the obesity scale, with a rate of 35.7%--fourth among U.S. cities with the highest obesity rates.  

“It’s disappointing because I know that we could do better and be better as a community,” says Bertha Lopez, the Community Health Director for Yakima Valley Memorial Hospital. “When I think of the indicators and what factors that contribute to obesity, I really think it’s really related to social determinants of health,” says Lopez.

As in Bellingham, economics, education and demographics are the determinants that affect Yakima’s overall health.

The Yakima Valley is well known for producing an abundance of fruits and vegetables. However, Lopez says that many people there struggle to afford those healthy foods year round.

More than 22% of the county population lives below the federal poverty level, and one in six households in Yakima are food insecure -- that is, unable to consistently access nutritious and adequate amounts of food. In addition, only 74% of Yakima residents have graduated from high school, and 25 percent of Yakima County adults do not have health insurance.

These factors apply to many of Yakima County’s 75,000+ migrant and seasonal farmworkers and their dependents. Lopez suggests that these workers have strenuous work obligations (such as working multiple jobs, long hours, etc.), so many are led to make unhealthy lifestyle choices.

“[They] can’t come home and prepare fresh meals, and they’re making quick choices (such as fast food) for their families,” says Lopez. “Some people may not have the time or energy to incorporate physical activity into their daily life, and those are two critical factors in improving the obesity epidemic in our county.”

Adriana Magaña knows these challenges. Her husband, Jesus, works late nights at a Yakima fruit warehouse, and her family struggles with weight issues that affect their health.

“First of all, my daughter (Anna) has asthma and she wasn’t able to exercise,” says Adriana. “[Also] my husband suffered a stroke a stroke and being overweight was harming him.”

The Magaña family has battled weight related health issues. The family has worked with a nutrition educator recommended through a Yakima Valley community health clinic to change their diet.

Adriana knew her family had to change their diet and lifestyle—what the family ate, how much they ate, and a lack of exercise were problems. A community health clinic referred the Magañas to a nutrition education course taught by Jasmine Silva of WSU Extension.

“Typical family, probably living under the same circumstances as the vast majority of families that we work with, and eating like everyone else,” says Silva, of the Magañas. She teaches these nutrition courses throughout the Yakima Valley, working with a growing Latino community that’s now 47 percent of the population in Yakima County.

Says Silva, “Most of our hispanic families have assimilated to the American diet.”

So Silva’s focus is on educating families like the Magañas about choosing a healthy diet that can help to prevent obesity and chronic illness—things like choosing whole grains over refined grains.

“Two out of three children born after the year 2000 are most likely to have complications of [Type II] diabetes. And one out of two children if they’re Hispanic or African-American, that’s 50 percent,” noted Silva. “So our classes are important to help reduce those rates, to give people the knowledge and even the hope to live to their maximum potential.”

Knowledge and hope are also big parts of Yakima Valley Memorial Hospital’s effort to combat obesity and diabetes. ACT classes, or “Actively Changing Together”, have shown success in helping overweight children and their parents through education of a healthy lifestyle.

Nutrition educator Jasmine Silva of WSU Extensions instructs women from underserved communities about how to improve their diets.

“So we’re really incorporating the family dynamics—spend time playing outside. Eating meals together and really helping not only kids, [but also] the parents, to make better purchasing choices,” says Lopez. “So when they go to the store, they’re purchasing healthier options so they know how to prepare them.”

Back to the Magaña family. There have been changes. Since taking the nutrition education class, Adriana pays more attention to what the family eats and the way she prepares the meals.

Says Adriana, “I learned what type of cooking oil I should use, how much I should use, how much sugar, and how much water we should drink.”

The family has lost weight and their health problems have lessened. Still, it’s an ongoing challenge for the Magañas and many others in the Yakima Valley.

Anna Magaña cuts fruit as her mother, Adriana, prepares dinner.  Since Adriana took the nutrition education class, the Magaña family now munches on fruits and vegetables while they wait for their main dish to be served.

Lopez thinks that the Yakima family culture needs to change in order to see a meaningful change in the health of Yakima’s population.

“We know that if you have healthy habits, your children will adopt those,” says Lopez. “And so hope is that we start embedding those healthy habits in to the family households so that their future generations will adapt those.”

Again, there is no single factor that determines obesity rates. The contrasting obesity rates of Bellingham and Yakima are not quirks of geography, ethnicity or even contrasting lifestyles. It’s many factors that come together in these two very different cities.



Made possible in part by

Stephen Hegg

Stephen is a 25-year veteran of KCTS, producing a wide range of cultural and public affairs series, documentaries and arts programming.  His credits include PIE, Something in the Water  (PBS feature on Seattle’s indie music scene), the gala opening of Benaroya Hall, and documentaries on Asahel and Edward Curtis, Dan Sullivan and Doris Chase.  Seattle-born, Hegg is a graduate of Whitworth University and is also an accomplished violinist and avid cyclist.

More stories by Stephen Hegg

Enrique Cerna

The son of Mexican immigrants, Enrique Cerna was born and raised in the Yakima Valley.  Enrique joined KCTS 9 in January, 1995. He has anchored current affairs programs, moderated statewide political debates, produced and reported stories for national PBS programs in addition to local documentaries on social and juvenile justice, the environment and Latinos in Washington State.

Enrique has earned nine Northwest Emmy Awards and numerous other honors. In June, 2013, he was inducted into the National Academy of Television Arts and Sciences Northwest Chapter’s Silver Circle for his work as a television professional.

More stories by Enrique Cerna

Alex Tran

Alexander Tran is a production intern at KCTS. Currently a senior at the University of Washington studying journalism, Alexander has also interned at KING-TV and was awarded the Northwest Asian Weekly Scholarship in 2014. He is set to commission into the United States Air Force as an officer this June.


More stories by Alex Tran

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This is a great article and all, and imma letchu finish, but Sumas is the northernmost city of Washington. For that matter, Blaine is pretty close too, even Lynden or Everson are more north, and Ferndale. Getcha act together and look at a map before writing anything about geography. "Bellingham, the northernmost city in the contiguous U.S." pah!

Key word "City". Bellingham is a small city. Ferndale, Lynden, Sumas are not cities.

This is so obvious it hurts me to have to say it.
I was a single mother on welfare. Then I got a job, worked 8.5 hours a day, rode the bus to daycare, had to do everything else after 6.30 pm or on the weekend.
Time for shopping, cooking, going to the laundromat, homework, then he started little league. We had no time or money for anything else.

PS I lived in MPLS for 8 years. It's a super great city if you have the money to rise above the horrible summer and winter temps. I was very happy there but the weather drove me out. I will never have the money for an air conditioned house, a heated garage, sports equipment and travel to lakes, mountains.

Money doesn't make you happy. But it does make life much easier.