title: Socioeconomic and food-related physical characteristics of the neighbourhood environment are associated with body mass index.
abstract: OBJECTIVE
  To determine whether socioeconomic and food-related physical characteristics of the neighbourhood are associated with body mass index (BMI; kg/m(2)) independently of individual-level sociodemographic and behavioural characteristics.
  
  
  METHODS
  Observational study using (1) individual-level data previously gathered in five cross-sectional surveys conducted by the Stanford Heart Disease Prevention Program between 1979 and 1990 and (2) neighbourhood-level data from (a) the census to describe socioeconomic characteristics and (b) data obtained from government and commercial sources to describe exposure to different types of retail food stores as measured by store proximity, and count of stores per square mile. Data were analysed using multilevel modelling procedures. The setting was 82 neighbourhoods in agricultural regions of California.
  
  
  METHODS
  7595 adults, aged 25-74 years.
  
  
  RESULTS
  After adjusting for age, gender, ethnicity, individual-level socioeconomic status, smoking, physical activity and nutrition knowledge, it was found that (1) adults who lived in low socioeconomic neighbourhoods had a higher mean BMI than adults who lived in high socioeconomic neighbourhoods; (2) higher neighbourhood density of small grocery stores was associated with higher BMI among women; and (3) closer proximity to chain supermarkets was associated with higher BMI among women.
  
  
  CONCLUSIONS
  Living in low socioeconomic neighbourhoods, and in environments where healthy food is not readily available, is found to be associated with increased obesity risk. Unlike other studies which examined populations in other parts of the US, a positive association between living close to supermarkets and reduced obesity risk was not found in this study. A better understanding of the mechanisms by which neighbourhood physical characteristics influence obesity risk is needed.
authors.affiliation: School of Public Health, University of California at Berkeley, Berkeley, CA, USA. maywang@berkeley.edu
authors.forename: May C
authors.initials: MC
authors.lastname: Wang
authors.forename: Soowon
authors.initials: S
authors.lastname: Kim
authors.forename: Alma A
authors.initials: AA
authors.lastname: Gonzalez
authors.forename: Kara E
authors.initials: KE
authors.lastname: MacLeod
authors.forename: Marilyn A
authors.initials: MA
authors.lastname: Winkleby
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003132:Commerce; D004779:Environment Design; D005260:Female; D005523:Food Supply; D015438:Health Behavior; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology; D012111:Residence Characteristics; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States