Built and Social Environments. Associations with Adolescent Overweight and Activity

Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota 55455-1015, USA.
American Journal of Preventive Medicine (Impact Factor: 4.53). 09/2006; 31(2):109-17. DOI: 10.1016/j.amepre.2006.03.026
Source: PubMed

ABSTRACT Little is known about the patterning of neighborhood characteristics, beyond the basic urban, rural, suburban trichotomy, and its impact on physical activity (PA) and overweight.
Nationally representative data (National Longitudinal Study of Adolescent Health, 1994-1995, n = 20,745) were collected. Weight, height, PA, and sedentary behavior were self-reported. Using diverse measures of the participants' residential neighborhoods (e.g., socioeconomic status, crime, road type, street connectivity, PA recreation facilities), cluster analyses identified homogeneous groups of adolescents sharing neighborhood characteristics. Poisson regression predicted relative risk (RR) of being physically active (five or more bouts/week of moderate to vigorous PA) and overweight (body mass index equal or greater than the 95th percentile, Centers for Disease Control and Prevention/National Center for Health Statistics growth curves).
Six robust neighborhood patterns were identified: (1) rural working class; (2) exurban; (3) newer suburban; (4) upper-middle class, older suburban; (5) mixed-race urban; and (6) low-socioeconomic-status (SES) inner-city areas. Compared to adolescents living in newer suburbs, those in rural working-class (adjusted RR[ARR] = 1.38, 95% confidence interval [CI] = 1.13-1.69), exurban (ARR = 1.30, CI = 1.04-1.64), and mixed-race urban (ARR = 1.31, CI = 1.05-1.64) neighborhoods were more likely to be overweight, independent of individual SES, age, and race/ethnicity. Adolescents living in older suburban areas were more likely to be physically active than residents of newer suburbs (ARR = 1.11, CI = 1.04-1.18). Those living in low-SES inner-city neighborhoods were more likely to be active, though not significantly so, compared to mixed-race urban residents (ARR = 1.09, CI = 1.00-1.18).
These findings demonstrate disadvantageous associations between specific rural and urban environments and behavior, illustrating important effects of the neighborhood on health and the inherent complexity of assessing residential landscapes across the United States. Simple classical urban-suburban-rural measures mask these important complexities.

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Available from: Penny Gordon-Larsen, Sep 28, 2015
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    • "There are two dominant approaches to creating these measures of the built environment (Fig. 1). Radial, or Euclidean, buffers are created by drawing a straight line out a given distance from a home address creating a circle that is used to define the built environment (Berke et al., 2007, Rutt and Coleman, 2005, Nelson et al., 2006). While radial buffers may theoretically be more representative of the built environment that may influence behavior compared to administrative boundaries due to the issues outlined above, radial buffers may be less likely to represent the " true " relevant spatial context in areas with natural features such as bodies of water or built features such as railways or poorly connected roads. "
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    ABSTRACT: Uncertainty in the relevant spatial context may drive heterogeneity in findings on the built environment and energy balance. To estimate the effect of this uncertainty, we conducted a sensitivity analysis defining intersection and business densities and counts within different buffer sizes and shapes on associations with self-reported walking and body mass index. Linear regression results indicated that the scale and shape of buffers influenced study results and may partly explain the inconsistent findings in the built environment and energy balance literature.
    Health & Place 03/2014; 27C:162-170. DOI:10.1016/j.healthplace.2014.02.003 · 2.81 Impact Factor
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    • "Researchers of child and adolescent obesity have mainly focused on individual factors such as gender, socio-economic position, physical activity, sedentary habits, nutrition and sleep duration [12,13,19]. Evidence also suggests that environmental and family factors influence adopted habits, particularly in children [14-16,20,21]. The neighborhood environment can include both physical aspects, which create opportunities or barriers for obesogenic behaviors, and social aspects of perceived safety or facility availability [22,23]. "
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    ABSTRACT: There is a growing worldwide trend of obesity in children. Identifying the causes and modifiable factors associated with child obesity is important in order to design effective public health strategies.Our objective was to provide empirical evidence of the association that some individual and environmental factors may have with child excess weight. A cross-sectional study was performed using multi-stage probability sampling of 978 Spanish children aged between 8 and 17 years, with objectively measured height and weight, along with other individual, family and neighborhood variables. Crude and adjusted odds ratios were calculated. In 2012, 4 in 10 children were either overweight or obese with a higher prevalence amongst males and in the 8-12 year age group. Child obesity was associated negatively with the socio-economic status of the adult responsible for the child's diet, OR 0.78 (CI95% 0.59-1.00), girls OR 0.75 (CI95% 0.57-0.99), older age of the child (0.41; CI95% 0.31-0.55), daily breakfast (OR 0.59; p = 0.028) and half an hour or more of physical activity every day. No association was found for neighborhood variables relating to perceived neighborhood quality and safety. This study identifies potential modifiable factors such as physical activity, daily breakfast and caregiver education as areas for public health policies. To be successful, an intervention should take into account both individual and family factors when designing prevention strategies to combat the worldwide epidemic of child excess weight.
    BMC Pediatrics 01/2014; 14(1):3. DOI:10.1186/1471-2431-14-3 · 1.93 Impact Factor
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    • "The Social Cognitive Theory proposes that personal, behavioral, and socio-environmental factors work in a dynamic and reciprocal fashion to influence health behavior [14]. Previous etiological research studies among youth have found that weight status is influenced by factors both at the individual and environmental levels [16,17]; thus, the Social Cognitive Theory is an appropriate framework for exploring factors that may increase the risk of weight gain over time. To allow for longitudinal comparisons, key items from the Project EAT-I survey were retained at EAT-III. "
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    ABSTRACT: Background The objective of this study was to identify 10-year longitudinal predictors of overweight incidence during the transition from adolescence to young adulthood. Methods Data were from Project EAT (Eating and Activity in Teens and Young Adults). A diverse, population-based cohort (N = 2,134) completed baseline surveys in 1998–1999 (mean age = 15.0±1.6, ‘adolescence’) and follow-up surveys in 2008–2009 (mean age = 25.4±1.7, ‘young adulthood’). Surveys assessed personal, behavioral and socio-environmental factors hypothesized to be of relevance to obesity, in addition to height and weight. Multivariable logistic regression was used to estimate the adjusted odds for each personal, behavioral and socio-environmental factor at baseline, and 10-year changes for these factors, among non-overweight adolescents (n = 1,643) being predictive of the incidence of overweight (BMI ≥ 25) at 10-year follow-up. Results At 10-year follow-up, 51% of young adults were overweight (26% increase from baseline). Among females and males, higher levels of body dissatisfaction, weight concerns, unhealthy weight control behaviors (e.g., fasting, purging), dieting, binge eating, weight-related teasing, and parental weight-related concerns and behaviors during adolescence and/or increases in these factors over the study period predicted the incidence of overweight at 10-year follow-up. Females with higher levels of whole grain intake and breakfast and dinner consumption frequency during adolescence were protected against becoming overweight. Among males, increases in vegetable intake protected against the incidence of overweight 10 years later. Conclusions Findings suggest that obesity prevention interventions for adolescents should address weight-specific factors from within the domains of personal, behavioral, and socio-environmental factors such as promoting positive body image, decreasing unhealthy weight control behaviors, and limiting negative weight talk.
    International Journal of Behavioral Nutrition and Physical Activity 03/2013; 10(1):37. DOI:10.1186/1479-5868-10-37 · 4.11 Impact Factor
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