title: Associations between neighborhood amenity density and health indicators among rural and urban youth.
abstract: OBJECTIVE
  To examine associations between the built/social environment (neighborhood amenity density, crime) and health indicators (body mass index [BMI] percentile, cardiovascular fitness, and time spent in moderate to vigorous physical activity [MVPA]) among rural and urban youth.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Eastern North Carolina.
  
  
  METHODS
  Youth (n = 296) were recruited from three middle schools.
  
  
  METHODS
  Neighborhood density was estimated using Walk Score. Crime was assessed using Regional Analysis and Information Sharing online. BMI percentiles were calculated from measured height and weight. Cardiovascular fitness was estimated using heart rate measured at the conclusion of a 3-minute step test. Time spent in MVPA was measured objectively via accelerometer.
  
  
  METHODS
  Bivariate and multivariate statistics were used to examine associations between Walk Score, crime, BMI percentile, cardiovascular fitness (as measured via heart rate), and MVPA.
  
  
  RESULTS
  Walk Score was positively correlated with crime. There were positive, statistically significant associations between Walk Score and (1) BMI percentile (p = .0223) and (2) heart rate (p = .0044), and (3) inverse associations between Walk Score and MVPA (p = .0042), indicating that high neighborhood density was associated with greater BMI percentiles, lower fitness, and less MVPA among urban youth.
  
  
  CONCLUSIONS
  These counterintuitive findings may be due to the negative effect of crime on health indicators, which may outweigh potential positive health impacts of high neighborhood amenity density.
authors: Department of Public Health, East Carolina University, 600 Moye Boulevard, MS 660, Greenville, SC 27834, USA. jilcotts@ecu.edu
authors: Stephanie B Jilcott
authors: SB
authors: Pitts
authors: Lucas J
authors: LJ
authors: Carr
authors: Jason
authors: J
authors: Brinkley
authors: James Langford
authors: JL
authors: Byrd
authors: Thomas
authors: T
authors: Crawford
authors: Justin B
authors: JB
authors: Moore
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D003415:Crime / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009043:Motor Activity; D015999:Multivariate Analysis; D009657:North Carolina; D011156:Population Density; D012424:Rural Population; D014505:Urban Population