title: Disentangling neighborhood contextual associations with child body mass index, diet, and physical activity: the role of built, socioeconomic, and social environments.
abstract: Obesity prevalence among US children and adolescents has tripled in the past three decades. Consequently, dramatic increases in chronic disease incidence are expected, particularly among populations already experiencing health disparities. Recent evidence identifies characteristics of "obesogenic" neighborhood environments that affect weight and weight-related behaviors. This study aimed to examine associations between built, socioeconomic, and social characteristics of a child's residential environment on body mass index (BMI), diet, and physical activity. We focused on pre-adolescent children living in New Haven, Connecticut to better understand neighborhood environments' contribution to persistent health disparities. Participants were 1048 fifth and sixth grade students who completed school-based health surveys and physical measures in fall 2009. Student data were linked to US Census, parks, retailer, and crime data. Analyses were conducted using multilevel modeling. Property crimes and living further from a grocery store were associated with higher BMI. Students living within a 5-min walk of a fast food outlet had higher BMI, and those living in a tract with higher density of fast food outlets reported less frequent healthy eating and more frequent unhealthy eating. Students' reported perceptions of access to parks, playgrounds, and gyms were associated with more frequent healthy eating and exercise. Students living in more affluent neighborhoods reported more frequent healthy eating, less unhealthy eating, and less screen time. Neighborhood social ties were positively associated with frequency of exercise. In conclusion, distinct domains of neighborhood environment characteristics were independently related to children's BMI and health behaviors. Findings link healthy behaviors with built, social, and socioeconomic environment assets (access to parks, social ties, affluence), and unhealthy behaviors with built environment inhibitors (access to fast food outlets), suggesting neighborhood environments are an important level at which to intervene to prevent childhood obesity and its adverse consequences.
authors: CARE: Community Alliance for Research and Engagement, Yale School of Public Health, USA. ac3343@drexel.edu
authors: Amy
authors: A
authors: Carroll-Scott
authors: Kathryn
authors: K
authors: Gilstad-Hayden
authors: Lisa
authors: L
authors: Rosenthal
authors: Susan M
authors: SM
authors: Peters
authors: Catherine
authors: C
authors: McCaslin
authors: Rebecca
authors: R
authors: Joyce
authors: Jeannette R
authors: JR
authors: Ickovics
mesh_terms: D015992:Body Mass Index; D002648:Child; D003237:Connecticut / Q000453:epidemiology; D004032:Diet / Q000706:statistics & numerical data; D004779:Environment Design / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009043:Motor Activity; D063766:Pediatric Obesity / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D064890:Social Determinants of Health; D012931:Social Environment; D012959:Socioeconomic Factors
keywords: Built environment; Health behaviors; Health disparities; Neighborhood; New Haven, Connecticut, USA; Social environment; Socioeconomic status
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