Effects of neighborhood walkability on healthy weight: Assessing selection and causal influences (original) (raw)
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International Journal of Behavioral Nutrition and Physical Activity, 2013
Background: A burgeoning literature links attributes of neighbourhoods' built environments to residents' physical activity, food and transportation choices, weight, and/or obesity risk. In cross-sectional studies, non-random residential selection impedes researchers' ability to conclude that neighbourhood environments cause these outcomes. Methods: Cross-sectional data for the current study are based on 14,689 non-Hispanic white women living in Salt Lake County, Utah, USA. Instrumental variables techniques are used to adjust for the possibility that neighbourhoods may affect weight but heavier or lighter women may also choose to live in certain neighbourhoods. All analyses control for the average BMI of siblings and thus familial predisposition for overweight/obesity, which is often an omitted variable in past studies.
Background: The increasing prevalence of overweight and obesity is a public health concern in the United States. There is a small but growing body of literature examining the relationship between neighborhood level characteristics, physical activity and weight status. However, to date, none of theses studies have examined the association between new urbanist communities and weight status. Objective: To examine the prevalence of overweight, obesity and body mass index of household heads in a new urbanist neighborhood relative to household heads of comparable conventional suburban neighborhoods. Method: Using a quasi-experimental design, a new urbanist neighborhood and five conventional suburban neighborhoods in central North Carolina were matched on age of development, assessed property values and regional accessibility. Self-reported height, weight, physical activity and travel behaviors were derived through a questionnaire and travel diary mailed to the heads of household in each n...
Change in Neighborhood Socioeconomic Status and Weight Gain
American Journal of Preventive Medicine, 2015
Introduction-Despite a proposed connection between neighborhood environment and obesity, few longitudinal studies have examined the relationship between change in neighborhood socioeconomic deprivation, as defined by moving between neighborhoods, and change in body weight. The purpose of this study is to examine the longitudinal relationship between moving to more socioeconomically deprived neighborhoods and weight gain as a cardiovascular risk factor. Methods-Weight (kg) was measured in the Dallas Heart Study (DHS), a multiethnic cohort aged 18-65 years, at baseline (2000-2002) and 7-year follow-up (2007-2009, N=1,835). Data were analyzed in 2013-2014. Geocoded addresses were linked to Dallas County, TX census block groups. A block group-level neighborhood deprivation index (NDI) was created. Multilevel difference-indifference models with random effects and a Heckman correction factor (HCF) determined weight change relative to NDI change. Results-Forty-nine percent of the DHS population moved (263 to higher NDI, 586 to lower NDI, 47 within same NDI), with blacks more likely to move than whites or Hispanics (p<0.01), but similar baseline BMI and waist circumference were observed in movers vs. non-movers
Running to the store? The relationship between neighborhood environments and the risk of obesity
2009
We expand the search for modifiable features of neighborhood environments that alter obesity risk in two ways. First, we examine residents' access to neighborhood retail food options in combination with neighborhood features that facilitate physical activity. Second, we evaluate neighborhood features for both low income and non-low income neighborhoods (bottom quartile of median neighborhood income vs. the top three quartiles).
From neighborhood design and food options to residents’ weight status
Appetite, 2011
This study examined associations of accessibility, availability, price, and quality of food choices and neighborhood urban design with weight status and utilitarian walking. To account for self-selection bias, data on adult residents of a middle-to-high-income neighborhood were used. Participants kept a 2-day activity/travel diary and self-reported socio-demographics, height, and weight. Geographic Information Systems data were used to objectively quantify walking-related aspects of urban design, and number of and distance to food outlets within respondents' 1 km residential buffers. Food outlets were audited for availability, price, and quality of healthful food choices. Number of convenience stores and in-store healthful food choices were positively related to walking for errands which, in turn, was predictive of lower risk of being overweight/obese. Negative associations with overweight/obesity unexplained by walking were found for number of grocery stores and healthful food choices in sit-down restaurants. Aspects of urban form and food environment were associated with walking for eating purposes which, however, was not predictive of overweight/obesity. Access to diverse destinations, food outlets and healthful food choices may promote pedestrian activity and contribute to better weight regulation. Accessibility and availability of healthful food choices may lower the risk of overweight/obesity by providing opportunities for healthier dietary patterns. ß
The Relationship Between Neighborhood Quality and Obesity Among Children
2009
It has long been posited by scientists that we need to have a better understanding in the role that larger contextual factors -like neighborhood quality and the built environment -may have on the nation's obesity crisis. This paper explores whether maternal perceptions of neighborhood quality affect children's bodyweight outcomes, and whether racial and ethnic differences in such perceptions may explain any of the hitherto unexplained gap in bodyweight and obesity prevalence among Whites and minorities. The project uses data from the NLSY79 and the CoNLSY datasets. Results indicate that overall neighborhood quality is not significantly related to children's bodyweight. However, one particular characteristic, namely whether or not the mother believes there is enough police protection in the neighborhood, is related. Lack of police protection has robust and significant effects on the BMI-percentile of the children, though it has less robust effects on the risk of becoming obese per se. Finally, there are differences in perceptions about adequate police protection in their neighborhood between Whites and minorities which remain after controlling for other socio-economic characteristics like maternal education, family income and family structure. However, these differences play a minor role in explaining part of the gap in bodyweight between White and minority children.
Social Science & Medicine, 2008
Past research has observed inverse associations between neighborhood and personal level measures of socioeconomic status and body mass index (BMI), but has not assessed how personal and neighborhood level measures might interact together to predict BMI. Using a sample of 13,102 adult residents of New York City who participated in a health survey, cross-sectional multi-level analyses assessed whether personal income, education and Zip code level poverty rates were associated with BMI. Demographic, income, education and objectively measured height and weight data were collected in the survey and poverty rates and the proportion of Black and Hispanic residents in the subject's Zip code were retrieved from the 2000 Census. Zip code level population density and land use mix, indices of neighborhood walk-ability which are often higher in lower income neighborhoods and are associated with lower BMI, were also measured. After controlling for individual and Zip code level demographic characteristics, increasing income was associated with lower BMI in women but not in men, and college and graduate level education was associated with lower BMI in both men and women. After control for income and individual and Zip code level demographic characteristics, higher Zip code poverty rate was unassociated with BMI. However, as expected, indices of neighborhood walk-ability acted as substantial inverse confounders in the relationship between Zip code poverty rate and BMI. After further adjustment for indices of neighborhood walk-ability, Zip code poverty rate became significantly, and positively associated with BMI in women. Among women, the inverse association between income and BMI was significantly stronger in richer compared to poorer Zip codes. In men and women, the association between college and graduate education and lower BMI was significantly stronger in richer versus poorer Zip codes. These analyses suggest that neighborhood socioeconomic context influences how personal socioeconomic status is measured to influence body size.
Using data from the 1994–2008 National Longitudinal Study of Adult Health (Add Health), this research examines the relationship between residential mobility and weight gain over time among urban and non-urban young adults. It is theorized that changes in residence act as a barrier to achieving an active lifestyle, which would increase an individual’s body mass index (BMI) over time. Relying on linear mixed-effects growth curve models, the results indicate that mobility is protective against weight gain over time after controlling for sociodemographic characteristics. For young adults who are residentially stable in urban neighborhoods, increases in physical activity are associated with a linear decline in BMI. In non-urban areas where respondents are residentially mobile, body weight does not fluctuate as sedentary behavior increases. However, in those areas, weight increases as sedentary behavior increases for those who did not move. Overall, the results suggest that the effect of mobility on weight gain is partially due to the kind of health behaviors that one engages in as well as whether or not one lives in an urban area. Policies geared toward relocating residents (such as Moving to Opportunity), and neighborhood processes that can lead individuals to change residences (such as foreclosures or gentrification) may have adverse health effects depending on whether they are occurring in urban or non-urban areas.