Geographic variation in the relationship between body mass index and the built environment

PREVENTIVE MEDICINE

卷:100

Article

Adachi-Mejia, Anna M.^1,2,3  Lee, Chanam⁴  Lee, Chunkuen⁴  Carlos, Heather A.^1,2  Saelens, Brian E.^5,6  Berke, Ethan M.^1,2,3  Doescher, Mark P.^7,8 

[1] Geisel Sch Med Dartmouth, Lebanon, NH USA

[2] Norris Cotton Canc Ctr Dartmouth Hitchcock, Canc Control Res Program, HB 7925, Lebanon, NH 03756 USA

[3] Dartmouth Inst Hlth Policy & Clin Practice, Lebanon, NH USA

[4] Texas A&M Univ, Dept Landscape Architecture & Urban Planning, College Stn, TX USA

[5] Seattle Childrens Res Inst, Seattle, WA USA

[6] Univ Washington, Sch Med, Seattle, WA USA

[7] Univ Washington, Sch Med, Dept Family Med, Seattle, WA 98195 USA

[8] Univ Oklahoma, Hlth Sci Ctr, Peggy & Charles Stephenson Canc Ctr, Oklahoma City, OK USA

关键词: Built environment;    Physical activity;    Geographic information systems (GIS);    Perception;    Objective measures;    Rural;    Environment design;    Epidemiological methods;    Obesity;    Land use;   

DOI  :  10.1016/j.ypmed.2017.03.018

来源: Elsevier

【 摘 要 】

Studies examining associations between weight status and neighborhood built environment (BE) have shown inconsistent results and have generally focused on urban settings. However, many Americans do not live in metropolitan areas and BE impacts may be different outside of metropolitan areas. We sought to examine whether the relationship between body mass index (BMI) and neighborhood BE exists and varies by geographic region across small towns in the United States. We conducted telephone surveys with 2156 adults and geographic information systems data in nine towns located within three geographic regions (Northeast, Texas, Washington) in 2011 and 2012. Multiple regression models examined the relationship between individual BMI and BE measures. Most physical activity variables were significantly associated with lower BMI in all geographic regions. We saw variation across geographic region in the relationship between characteristics of the BE variables and BMI. Some perceived and objectively-measured characteristics of the BE were significantly associated with adult BMI, but significant relationships varied by geographic region. For example, in the Northeast, perceived attractiveness of the neighborhood as a reason for why they chose to live there was associated with lower BMI; in Texas, the perceived presence of a fast food restaurant was negatively associated with BMI; in Washington, perceived presence of trees along the streets was associated with lower BMI. Our findings suggest that regional variation plays a role in the relationship between adult BMI and BE characteristics in small towns. Regardless of geographic location, interventions should encourage utilitarian walking and other forms of physical activity. (C) 2017 Elsevier Inc. All rights reserved.

【 授权许可】

Free