Area-based variations in obesity are more than a function of the food and physical activity environment : area-based variations in obesity.
This study examines the area-based variations in obesity from a community-based epidemiologic survey of Boston, MA, USA, using a geographic information system and multilevel modeling techniques. A combination of quantitative and qualitative methods was used to assess whether a function of the food and the physical activity (PA) environment can explain the body weight of residents. First, a series of multilevel analyses was conducted after accounting for the well-established individual determinants and capturing a wide range of environmental attributes to represent a more realistic portrayal of urban typology. Second, the results of multilevel analysis were framed into the theoretical model of area-based variations in obesity to qualitatively summarize the association of contextual factors with the body weight of residents. Based on the overall correlation, the area-based variations defined by a function of the food and PA environment seem to be insufficient in explaining the body weight of residents. By testing the cross-level interactions of gender and race/ethnicity with contextual factors, the results suggest that the concept of area-based variations in obesity will have to consider how residents behave differently within a given environment. More research is needed to better understand the contextual determinants of obesity so as to put forth population-wide interventions.
Advanced Studies Program, Graduate School of Design, Harvard University, Cambridge, MA, USA. moka@post.harvard.edu
Masayoshi
M
Oka
Carol L
CL
Link
Ichiro
I
Kawachi
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001900:Boston / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004779:Environment Design / Q000592:standards*; D005260:Female; D005523:Food Supply / Q000592:standards*; D040362:Geographic Information Systems; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D055361:Multilevel Analysis; D009765:Obesity / Q000453:epidemiology*; D012959:Socioeconomic Factors