Abstract
Objective:
The global obesity epidemic has been partially attributed to modern environments that encourage inactivity and overeating, yet few studies have examined specific features of the physical neighborhood environment that influence obesity. Using two different measurement methods, this study sought to identify and compare perceived and observed neighborhood indicators of obesity and a high-risk profile of being obese and inactive.
Design:
Cross-sectional telephone surveys (perceived) and street-scale environmental audits (observed) were conducted concurrently in two diverse US cities to assess recreational facility access, land use, transportation infrastructure and aesthetics.
Subjects:
A total of 1032 randomly selected urban residents (20% obese, 32% black, 65% female).
Analysis:
Bivariate and multivariate logistic regression analyses were conducted to estimate the association (adjusted prevalence odds ratio (aOR)) between the primary outcome (obese vs normal weight) and perceived and observed environmental indicators, controlling for demographic variables.
Results:
Being obese was significantly associated with perceived indicators of no nearby nonresidential destinations (aOR=2.2), absence of sidewalks (aOR=2.2), unpleasant community (aOR=3.1) and lack of interesting sites (aOR=4.8) and observed indicators of poor sidewalk quality (aOR=2.1), physical disorder (aOR=4.0) and presence of garbage (aOR=3.7). Perceived and observed indicators of land use and aesthetics were the most robust neighborhood correlates of obesity in multivariate analyses.
Conclusions:
The findings contribute substantially to the growing evidence base of community-level correlates of obesity and suggest salient environmental and policy intervention strategies that may reduce population-level obesity prevalence. Continued use of both measurement methods is recommended to clarify inconsistent associations across perceived and observed indicators within the same domain.
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Acknowledgements
We are grateful for the assistance of Rebeka Cook, Montenia Anderson, Cheryl Kelly, Kathy McMullen, Omar Brown, Dwayne Ellis, Glen Grant, Timothy Hill and Albert Spears in data collection, and of Michael Elliott in data management. We also thank C Tracy Orleans and Marla Hollander of the Robert Wood Johnson Foundation for their support throughout this project. This study was funded through The Robert Wood Johnson Foundation contract no. 051603, including support from the Centers for Disease Control and Prevention contract U48/DP000060-01 (Prevention Research Centers Program).
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Boehmer, T., Hoehner, C., Deshpande, A. et al. Perceived and observed neighborhood indicators of obesity among urban adults. Int J Obes 31, 968–977 (2007). https://doi.org/10.1038/sj.ijo.0803531
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DOI: https://doi.org/10.1038/sj.ijo.0803531
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