title: Geographic scale matters in detecting the relationship between neighbourhood food environments and obesity risk: an analysis of driver license records in Salt Lake County, Utah.
abstract: OBJECTIVE
  Empirical studies of the association between neighbourhood food environments and individual obesity risk have found mixed results. One possible cause of these mixed findings is the variation in neighbourhood geographic scale used. The purpose of this paper was to examine how various neighbourhood geographic scales affected the estimated relationship between food environments and obesity risk.
  
  
  METHODS
  Cross-sectional secondary data analysis.
  
  
  METHODS
  Salt Lake County, Utah, USA.
  
  
  METHODS
  403,305 Salt Lake County adults 25-64 in the Utah driver license database between 1995 and 2008.
  
  
  METHODS
  Utah driver license data were geo-linked to 2000 US Census data and Dun & Bradstreet business data. Food outlets were classified into the categories of large grocery stores, convenience stores, limited-service restaurants and full-service restaurants, and measured at four neighbourhood geographic scales: Census block group, Census tract, ZIP code and a 1 km buffer around the resident's house. These measures were regressed on individual obesity status using multilevel random intercept regressions.
  
  
  RESULTS
  Obesity.
  
  
  RESULTS
  Food environment was important for obesity but the scale of the relevant neighbourhood differs for different type of outlets: large grocery stores were not significant at all four geographic scales, limited-service restaurants at the medium-to-large scale (Census tract or larger) and convenience stores and full-service restaurants at the smallest scale (Census tract or smaller).
  
  
  CONCLUSIONS
  The choice of neighbourhood geographic scale can affect the estimated significance of the association between neighbourhood food environments and individual obesity risk. However, variations in geographic scale alone do not explain the mixed findings in the literature. If researchers are constrained to use one geographic scale with multiple categories of food outlets, using Census tract or 1 km buffer as the neighbourhood geographic unit is likely to allow researchers to detect most significant relationships.
authors.affiliation: Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Jessie X
authors.initials: JX
authors.lastname: Fan
authors.affiliation: Department of Family and Preventive Medicine & Population Science, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Heidi A
authors.initials: HA
authors.lastname: Hanson
authors.affiliation: Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Cathleen D
authors.initials: CD
authors.lastname: Zick
authors.affiliation: Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Brown
authors.affiliation: Department of Family and Consumer Studies, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Lori
authors.initials: L
authors.lastname: Kowaleski-Jones
authors.affiliation: Department of Family and Consumer Studies & Population Science, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA.
authors.forename: Ken R
authors.initials: KR
authors.lastname: Smith
mesh_terms: D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004777:Environment; D004812:Epidemiologic Methods; D057140:Fast Foods / Q000600:supply & distribution; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012147:Restaurants / Q000706:statistics & numerical data; D014589:Utah / Q000453:epidemiology
keywords: PREVENTIVE MEDICINE; PUBLIC HEALTH; SOCIAL MEDICINE