title: Neighborhood influences on girls' obesity risk across the transition to adolescence.
abstract: OBJECTIVE
  The neighborhoods in which children live, play, and eat provide an environmental context that may influence obesity risk and ameliorate or exacerbate health disparities. The current study examines whether neighborhood characteristics predict obesity in a prospective cohort of girls.
  
  
  METHODS
  Participants were 174 girls (aged 8-10 years at baseline), a subset from the Cohort Study of Young Girls' Nutrition, Environment, and Transitions. Trained observers completed street audits within a 0.25-mile radius around each girl's residence. Four scales (food and service retail, recreation, walkability, and physical disorder) were created from 40 observed neighborhood features. BMI was calculated from clinically measured height and weight. Obesity was defined as BMI-for-age ≥ 95%. Logistic regression models using generalized estimating equations were used to examine neighborhood influences on obesity risk over 4 years of follow-up, controlling for race/ethnicity, pubertal status, and baseline BMI. Fully adjusted models also controlled for household income, parent education, and a census tract measure of neighborhood socioeconomic status.
  
  
  RESULTS
  A 1-SD increase on the food and service retail scale was associated with a 2.27 (95% confidence interval, 1.42 to 3.61; P < .001) increased odds of being obese. A 1-SD increase in physical disorder was associated with a 2.41 (95% confidence interval, 1.31 to 4.44; P = .005) increased odds of being obese. Other neighborhood scales were not associated with risk for obesity.
  
  
  CONCLUSIONS
  Neighborhood food and retail environment and physical disorder around a girl's home predict risk for obesity across the transition from late childhood to adolescence.
authors.affiliation: Robert Wood Johnson Foundation Health and Society Scholar, University of California, San Francisco and Berkeley, California; hoytl@chc.ucsf.edu.
authors.forename: Lindsay T
authors.initials: LT
authors.lastname: Hoyt
authors.affiliation: Division of Research, Kaiser Permanente, Oakland, California;
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Kushi
authors.affiliation: Center for Health and Community.
authors.forename: Cindy W
authors.initials: CW
authors.lastname: Leung
authors.affiliation: Winship Cancer Institute, Emory University, Atlanta, Georgia; and.
authors.forename: Dana C
authors.initials: DC
authors.lastname: Nickleach
authors.affiliation: Center for Health and Community, Departments of Psychiatry and Pediatrics.
authors.forename: Nancy
authors.initials: N
authors.lastname: Adler
authors.affiliation: School of Public Health, University of California, Berkeley, California.
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
authors.affiliation: Epidemiology and Biostatistics, and.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Hiatt
authors.affiliation: Medicine, University of California, San Francisco, California;
authors.forename: Irene H
authors.initials: IH
authors.lastname: Yen
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D009765:Obesity / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment
keywords: adolescent development; neighborhood; obesity