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Using DMV records for obesity tracking
Daniel Morris, MS, PhD Oregon Environmental Public Health Tracking
April 1, 2013
See oregonpublichealth.org/events for more public health week events
Who gets to access personal info on DMV records?
• Police
• Elections officials
• Attorneys
• Financial institutions
• Collection agencies
• Process servers
• Health researchers
• Injured people
• Tow companies
• Private security
• Employers
• Toll facility owners
• Private investigators
• Motor vehicle manufacturers
• Insurers
Oregon Revised Statutes 802.179
ORS 802.179 (1): The Department of Transportation, upon request or as required by law, shall disclose personal information from a motor vehicle record to a government agency for use in carrying out its governmental functions.
Core public health
functions
Height Weight Range BMI Weight Status
5' 9"
124 lbs or less Below 18.5 Underweight
125 lbs to 168 lbs 18.5 to 24.9 Healthy
169 lbs to 202 lbs 25.0 to 29.9 Overweight
203 lbs or more 30 or higher Obese
Defining weight status
N Engl J Med. 2010 December 2; 363(23): 2211–2219. doi:10.1056/NEJMoa1000367.
Adult obesity and diabetes, U.S.
NHANES, NHIS
Data source: Oregon DMV records issued 2005-2012. PRELIMINARY
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
1910-1919 1920-1929 1930-1939 1940-1949 1950-1959 1960-1969
% f
lagg
ed
as
de
ceas
ed
Birth year
Underweight
Healthy weight
Overweight
Obese
Mortality rates from DMV records
Don’t people lie about their weight?
22
23
24
25
26
27
28
2003 2004 2005 2006 2007 2008 2009 2010
Mean
BM
I Mean BMI, Oregon BRFSS and DMV
Women DMV Women BRFSS Men DMV Men BRFSS
Age-adjusted estimates from Oregon BRFSS and DMV records, adults ages 18-84
Avg. diff = 2%
Avg. diff = 5%
0
0
500
1,000
1,500
2,000
2,5001
97
0
19
72
19
74
19
76
19
78
19
80
19
82
19
84
19
86
19
88
19
90
19
92
19
94
19
96
19
98
20
00
20
02
20
04
20
06
20
08
20
10
Ave
rage
dai
ly c
alo
rie
s p
er
cap
ita
Flour and cereal products
Added fats and oils anddairy fatsCaloric sweeteners
Meat, eggs, and nuts
Dairy
Vegetables
Fruit
Average daily per capita calories from the U.S. food availability,
adjusted for spoilage and other waste (USDA)
Food consumption
What changed?*
• Agriculture policies favoring overproduction
• Shareholder value movement
• Reagan-era deregulation
http://www.foodpolitics.com/wp-
content/uploads/Dissent_Nestle_12.pdf
*According to Marion Nestle
Restaurant
portion sizes
quadrupled
since the
1950s
Wansink, Brian and Collin R. Payne (2009), "The Joy of
Cooking Too Much: 70 Years of Calorie Increases in Classic
Recipes,"Annals of Internal Medicine, 150, 291-291.
0
50
100
150
200
250
300
350
400
450
1936 1946 1951 1963 1975 1997 2006Ave
rage
cal
ori
es
pe
r se
rvin
g
Edition
Average calories per serving in 18 classic recipes in The Joy of Cooking
Congressional Research Service (2012) Consumers and Food Price Inflation, data from USDA Economic Research Service
Food environment in Oregon
0
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
Dine-inrestaurants
Fast foodrestaurants
Conveniencestores
Grocery stores Produce stands
Nu
mb
er
Oregon Employment Department, 2010
Oregon Farmer’s Market Association
-
1,000
2,000
3,000
4,000
5,000
6,000
7,000
8,000
9,000
Restaurants Conveniencestores
Groceries Producestands
Nu
mb
er
Food deserts or food swamps?
USDA Food Access Research Atlas
Low income census tracts where a significant number of
households have low vehicle access or a significant number
or share of residents are more than 20 miles from the
nearest supermarket
Image from portlandoctopus.com
I haven’t updated my weight since
high school
23
24
25
26
27
28
291
98
8-1
99
2
19
83
-19
87
19
78
-19
82
19
73
-19
77
19
68
-19
72
19
63
-19
67
19
58
-19
62
19
53
-19
57
19
48
-19
52
19
43
-19
47
19
38
-19
42
19
33
-19
37
19
28
-19
32
Pre
-19
28
Me
an B
MI
Birth Year
BMI by Birth Cohort and Year, Males 2003 2004 2005 2006 2007 2008 2009 2010
0
Oregon DMV records issued 2003-2010
2008 American Time Use Survey
American Time Use
42
73
36
83
36
69
27
85
39
64
22
86
0
10
20
30
40
50
60
70
80
90
100
Grocery shopping andmeal prep
Primary eating anddrinking
Secondary eating Secondary drinking
Ave
rage
min
ute
s p
er
day
Healthy weight Overweight Obese
Energy drinks, 451 RTD Tea,
1,063 Sports
drinks, 1,378
Fruit beverages,
3,574
Bottled water, 9,109
Carbonated soft drinks,
13,565
U.S.
beverage
sales, 2011
(millions of
gallons)
Beverage World State of the Industry Reports - http://www.beverageworld.com/
Sugary drinks
About half of 2-year-
olds in Oregon have
a soda or other
sugary drink at least
once a week
Bernice Raveche Garnett, Kenneth D Rosenberg and Daniel S Morris. Consumption of soda and other sugar-sweetened beverages by 2-year-
olds: findings from a population-based survey. Public Health Nutrition, available on CJO2012. doi:10.1017/S1368980012004399.
About half of 2-year-
olds in Oregon have
a soda or other
sugary drink at least
once a week
Bernice Raveche Garnett, Kenneth D Rosenberg and Daniel S Morris. Consumption of soda and other sugar-sweetened beverages by 2-year-
olds: findings from a population-based survey. Public Health Nutrition, available on CJO2012. doi:10.1017/S1368980012004399.
Nutritional labeling
Photo: Associated Press
Restaurant Foods 30.7%
Carbonated Beverages
25.6%
Juice & Non-carbonated
Bevs. 10.7%
Snack Foods 8.3%
Breakfast Cereal 7.5%
Prepared Foods & Meals
5.7%
Candy & Frozen Desserts
5.5%
Dairy Products 4.8%
Baked Goods 0.7%
Fruits & Vegetables
0.6%
$9.6 billion in food marketing in 2009
Federal Trade Commission, A Review of Food Marketing to Children and Adolescents (2012). Data from 44 major food and beverage manufacturers, distributors and marketers
Federal Trade Commission, A Review of Food Marketing to Children and Adolescents (2012). Data from 44 major food and beverage manufacturers, distributors and marketers. Companies were required to report spending for “All Ages” only when they had child‐ or teen‐directed marketing for the product. Thus, the "All Ages" data reported here do not include any spending for products that did not have child‐ or teen‐directed marketing.
Marketing $ distribution
TV 41.2%
Other 14.0%
In‐Store 8.2%
Premiums 6.0%
Internet 5.7%
Print 5.1% Radio
4.1%
Athletic sponsorship 4.1%
In‐School 3.4%
Events 2.5%
Pack/Label 1.6%
Web 1.2%
Cross‐promotion licenses
0.9% Viral/WOM
0.8% Celebrity fees
0.5% Philanthropy 0.4%
Product Placement 0.3%
Movie/Video 0.2%
147 164
184
0
20
40
60
80
100
120
140
160
180
200
Healthy weight Overweight Obese
Min
ute
s Average daily TV time
Data source: USDA Economic Research Service, using data from 2006-2008 American Time Use Survey and ERS Eating & Health Module data
Trends in energy expended at work
Church TS, Thomas DM, Tudor-Locke C, Katzmarzyk PT, et al. (2011)
http://www.plosone.org/article/info:doi/10.1371/journal.pone.0019657
Transportation to work
1960 - 2009
Photo from onemorecyclist.wordpress.com, credited to e france
21 17
21 26
41
Average, allmodes
Walked,bicycled or
other means
Drove alone Carpooled Publictransportation
Ave
rage
tim
e t
o w
ork
, in
min
ute
s Commute time by mode in Oregon
Data source: American Community Survey 2006-2010
Data source: American Community Survey 2006-2010
Commuting in America III (2006): Third National report on commuting patterns and trends
Urban sprawl
Image from http://www.tranquilityokc.com
Community design for health
http://www.healthycommunitiesbydesign.org/
Investment
• Cost to acquire data from DMV: $900
• Staff time to geocode 1.5 million addresses
• Simple, standard analysis
Obesity in Oregon, 2006-2009
Oregon Obesity Percentage-adjusted
State Average: 24.5%
10% - 19.9%
20% - 25.9%
>= 26%
Lake
HarneyMalheur
Lane
Grant
Klamath
Douglas
Baker
Linn
Crook
Jackson
Coos
Curry
Deschutes
Jefferson
Josephine
Lincoln
Benton
Umatilla Wallowa
UnionMorrow
Sh
erm
anGilliam
Marion
Clackamas
Polk
Tillamook
Clatsop
Yamhill
Colu
mbia
Washington
Hood RiverMultnomah
Wasco
Wheeler
Data Source: Oregon BRFSS 2006-2009
metro RLIS.mxd
I5
I205
I84
SUNSET
HW
Y 217
I 405
I205
-I5
I5 F
WY-
I84
FWY
I5
I84
I5I5
I84
I84I405
I205
I405
BartonCarver
BoringTigard
Sylvan
Redland
Gresham
Stafford
Damascus
Sherwood
Tualatin
RockwoodPortland
Fairview
West Linn
Oak Grove
Milwaukie
BeavertonMaplewood
Lake Grove
West Slope
Eagle Creek
Russelville
Age‐adjusted mean BMI for adult residents ages 18 ‐ 84 in Census block groups in the Portland Metro area, Data are age‐adjusted to the 2000 U.S. Census standard population. Data source: Oregon driver licenses and ID cards issued 2003 ‐ 2010 provided by the Oregon Department of Transportation.
Legend23.4 - 25.1
25.2 - 26.0
26.1 - 26.7
26.8 - 27.4
27.5 - 30.9
BMI and economic status
Tract-level analysis using DMV records issued 2003-2010, American Community Survey 2006-2010
Protecting personal information
• Only publish aggregate statistics
• Strict policies on data access
39 states & territories collect height and weight
I.D. Checking Guide 2012. Drivers License Guide Company, Redwood City, CA.
DMV data
• Valuable resource for public health
• 10,000X greater resolution than survey data
• Reliably inaccurate
Thanks
Public Health Division
• Eric Main
• Mary Dinsdale
• Tara Chetock
• Marina Counter
• Jill Brackenbrough
• Curtis Cude
• Jae Douglas
• Dan Rubado
• Stacey Schubert
• Duyen Ngo
• Sami Stuchell
Oregon DMV
• Susie Hanlon
Oregon Department of Administrative Services
• Erik Endrulat
Texas A & M University
Questions?
Daniel Morris, MS, PhD Epidemiologist
Oregon Tracking Program
971-673-1210
healthoregon.org/epht
Data Portal: epht.oregon.gov
facebook.com/OregonEPHT
