title: A national study of neighborhood safety, outdoor play, television viewing, and obesity in preschool children.
abstract: OBJECTIVE
  To test the hypothesis that preschool children have a higher prevalence of obesity, spend less time playing outdoors, and spend more time watching television (TV) when they live in neighborhoods that their mothers perceive as unsafe.
  
  
  METHODS
  In a cross-sectional survey in 20 large US cities, mothers reported the average daily time of outdoor play and TV viewing for their 3-year-old children, and the children's BMI was measured. Maternal perception of neighborhood safety was assessed with the Neighborhood Environment for Children Rating Scales; the scale score was used to divide children into tertiles of neighborhood safety.
  
  
  RESULTS
  Of the 3141 children studied, 35% lived in households with incomes below the US poverty threshold. After adjustment for sociodemographic factors (household income and mothers' education, race/ethnicity, age, and marital status), obesity prevalence (BMI > or =95th percentile) did not differ in children from the least safe to the safest neighborhood safety tertile (18% vs 17% vs 20%) or in weekday (160 vs 151 vs 156 minutes/day) or weekend (233 vs 222 vs 222 minutes/day) outdoor play time. Children who lived in neighborhoods that were perceived by their mothers as the least safe watched more TV (201 vs 182 vs 185 minutes/day) and were more likely to watch >2 hours/day (66% vs 60% vs 62%). TV viewing and outdoor play minutes were not significantly correlated to each other or to BMI.
  
  
  CONCLUSIONS
  In a national sample of preschool children, mothers' perception of neighborhood safety was related to their children's TV viewing time but not to their outdoor play time or risk for obesity.
authors.affiliation: Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. burdette@email.chop.edu
authors.forename: Hillary L
authors.initials: HL
authors.lastname: Burdette
authors.forename: Robert C
authors.initials: RC
authors.lastname: Whitaker
mesh_terms: D001290:Attitude; D015992:Body Mass Index; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D015444:Exercise; D006801:Humans; D009035:Mothers / Q000523:psychology; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology; D010988:Play and Playthings; D011203:Poverty; D012111:Residence Characteristics; D012449:Safety; D012959:Socioeconomic Factors; D013690:Television; D014481:United States / Q000453:epidemiology