Overweight/obesity was associated with living on a highway, living on a street with no sidewalks or with sidewalks on one side only, and having poor access to four or more recreational facilities. ( 33 ) incorporated young children as well as adolescents, the results were shown for all age groups combined. Most articles (84%) reported a statistically significant positive association between some aspect of the built environment and obesity. It can generally be described as the man-made or modified structures that provide people with . In addition to these standard community design measures, Ellaway et al. How the Built Environment Contributes to the Adolescent Obesity Epidemic: A Multifaceted Approach. Both of these studies found significant positive associations between the measures of use of motorized transportation and risk of obesity. Built Environment The built environment includes homes, schools, workplaces, parks, farms, and roads. This review examines the published empirical evidence for the influence of the built environment on the risk of obesity. Adolescence is a critical life period marked by rapid growth and development, and it is typically characterized by an increasing need for autonomy and a desire to make lifestyle choices that conform to peer norms ( 87 , 88 ). YMCA, Young Men's Christian Association; BMI, body mass index; BRFSS, Behavioral Risk Factor Surveillance System; RR, relative risk; CI, confidence interval; CDC, Centers for Disease Control and Prevention; PR, prevalence ratio; WISEWOMEN, Well-Integrated Screening and Evaluation for Women Across the Nation; WIC, Women, Infants, and Children. The way the built environment is created can affect many daily decisions. The county-level, but not metropolitan-level, sprawl index was associated with BMI and risk of obesity. Article CAS Google Scholar The built environment touches all aspects of our lives, encompassing the buildings we live in, the distribution systems that provide us with water and electricity, and the roads, bridges, and transportation systems we use to get from place to place. The reference sections of 18 discussion/review articles, as well as of the 15 empirical papers, were examined for additional studies of the built environment and obesity. Of the 20 articles, 17 reported a statistically significant positive association between some aspect of the built environment and BMI. The three investigations in adolescents ( 44 , 47 , 49 ) used data from either the National Longitudinal Study of Adolescent Health ( 44 , 47 ) or the National Longitudinal Survey of Youth ( 49 ), where self-reported data on weight and height were collected and age- and sex-specific BMI percentiles were used to classify overweight. If the observations in Boston and Chicago are applicable to Cincinnati, it may be possible that access to safe play space, versus any play space, may be more relevant in the lives of these young children. With globalization, there is a possibility that western environmental models may be replicated in developing countries such as India, where the underlying genetic predisposition makes them particularly susceptible to . For example, data from the US Census provide inexpensive and easily available measures of some aspects of the built environment. Frank et al. Of the 20 studies reviewed, measurement of the built environment varied, with little overlap across studies (see table 2 for a list of measures). On the other hand, traditional individual-level studies, such as those examining physical inactivity and risk of overweight, are unable to investigate the role of group-level factors, such as the availability of recreational facilities within residential neighborhoods, in explaining variability in overweight between individuals ( 54 ). Odds of overweight declined with increasing number of physical activity facilities per census block group (for having one physical activity facility compared with no facility, odds ratio = 0.95, 95% CI: 0.9, 0.99). For studies that examined the density of food outlets, area measurements differed. A review of the literature, Measurement and long-term health risks of child and adolescent fatness, Risks and consequences of childhood and adolescent obesity, Preventing obesity in children and adolescents, Fighting obesity through the built environment, Causal web of societal influences on obesity prevalence, (Figure presented by Prof. Philip James at an obesity prevention workshop; available from the International Obesity Task Force at, Environmental contributions to the obesity epidemic, An ecological approach to the obesity pandemic, Halting the obesity epidemic: a public health policy approach, Residential environments and cardiovascular risk. Neighborhood was defined as a 3-km radius around the residence. Healthier diets that may reduce the risk of obesity cost more, and high-energy-density foods, which have been found to be associated with increased risk of obesity, cost less ( 86 ). Residential accessibility determines the destination, mode, and arguably even the frequency of home-based trips ( 64 ). A multilevel analysis of the relationship of metropolitan sprawl to the health of individuals, You are where you shop: grocery store locations, weight, and neighborhoods, The study of group-level factors in epidemiology: rethinking variables, study designs, and analytical approaches, State of disparities in cardiovascular health in the United States, What is the best measure of adiposity change in growing children: BMI, BMI %, BMI, African Americans' access to healthy food options in South Los Angeles restaurants, Improving the nutritional resource environment for healthy living through community-based participatory research, Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit, Neighborhood characteristics associated with the location of food stores and food service places, McDonald's restaurants and neighborhood deprivation in Scotland and England, Fruit and vegetable intake in African Americans: income and store characteristics, The contextual effect of the local food environment on residents' diets: The Atherosclerosis Risk in Communities Study, The determinants of daily travel-activity patterns: relative location and sociodemographic factors, Socioeconomics of urban travel: evidence from the 2001 National Household Travel Survey, Multilevel analysis: an introduction to basic and advanced multilevel modeling, Multilevel analysis in public health research, Geographical clustering of prostate cancer grade and stage at diagnosis, before and after adjustment for risk factors, Comparison of a spatial approach with the multilevel approach for investigating place effects on health: the example of healthcare utilization in France, Social environment and physical activity: a review of concepts and evidence, Neighborhood age structure and its implications for health, The Irvine-Minnesota Inventory to measure built environmentsdevelopment, Psychosocial and environmental factors associated with physical activity among city dwellers in regional Queensland, Environmental measures of physical activity supports: perception versus reality. As for the relationship between the built environment and obesity, emerging global evidence has revealed the indirect pathways by which the built environment influences the risk of obesity, but research on the elderly group is still limited, particularly for China. It is the focus of the majority of research on proximity of recreational and dietary facilities. Neighbourhood food environment and diettime for improved conceptual models? For example, distance and travel time to a resource such as a hospital are often of interest, because they capture one dimension of access to health care. Sidewalk availability, number and distance to physical activity facilities, mixed land use, intersection density, and slope (average change in elevation) were used as measures of the built environment. These articles demonstrate the recent interest in examining environmental influences of obesity risk and document a fruitful area of research. Built environment contributes to diabetes through access to physical activity and through stress, by affecting the sleep cycle. The reduction of waste will play important part in achieving the environmental and economic sustainability in this important sector. The index was based on the population density within census tracts that made up each metropolitan area. The use of adult definitions within this investigation may have introduced misclassification, which could have contributed to the null results. Examining models for spatial autocorrelation in the unexplained variance can reveal nonstationarity in the model and may shed light on important but overlooked small-area effects ( 70 , 71 ). Cross-sectional survey of 1,803 healthy sedentary workers and homemakers aged 1859 years living in areas within the top and bottom quintiles of social disadvantage in Perth, Australia, Three objectively measured variables, including the type of street the resident lived on (cul-de-sac, highway, or other), whether there were sidewalks (none or on one or both sides of the road), and a measure of poor spatial access to recreational facilities. To date, there is a growing evidence base pointing to the importance of the physical and social contexts within which individual behaviors are enacted. Abstract contributing factor to the U.S. national obesity epidemic is the built environment-the physical aspects of a community in which we live, work and engage in our everyday activities. Similarly, because it is the interaction of the individual with his or her environment that influences health, measures and concepts may differ for men and women, for families as compared with the elderly or children, and for persons or groups with relatively fewer or greater social or economic resources. , Megan M. Pinkston MA , Walker S. Carlos Poston PhD, MPH Add to Mendeley https://doi.org/10.1016/j.jada.2005.02.045 Get rights and content Abstract Biological, psychological, behavioral, and social factors are unable to fully explain or curtail the obesity epidemic. their risk of obesity. No association was found between proximity to playgrounds, proximity to fast-food restaurants, or neighborhood crime and risk of overweight or being at risk for overweight. Multilevel analytical tools will allow for simultaneous computation of the effects of group-level variables and individual-level variables on outcomes such as BMI. Oxford University Press is a department of the University of Oxford. Cross-sectional study of 2,692 adult female participants in the WISEWOMEN. A neighborhood walkability scale was developed using measures of residential density, mixed land use, and street connectivity. As adolescents begin to explore the environment around them independently of parental influences, the impact of the built environment may be a strong determinant in influencing behaviors regarding physical activity and diet. Research on the built environment in adults has not, for the most part, distinguished between the life stages of adulthood. An ad hoc committee will plan and conduct a 1-day public workshop that will examine how investments in the built environment and transportation contribute to the prevention and treatment of obesity and will explore how to advance their impact and add to the overall health and well-being of communities. ( 83 ) found that youths in high-poverty neighborhoods lived closer to playgrounds, but on average these playgrounds tended to be less safe than those in neighborhoods of higher socioeconomic status. In this study, Increased mixed land use and daily distance walked were associated with reduced obesity; increased time spent in a car was associated with increased obesity. Epidemiologic Reviews Copyright 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A. East is East or Is it? The majority of these studies simply adjusted for race/ethnicity within their analytical models. ( 7) The food that families keep at home and how family members share meals influences what and how much they eat. D. "Present bias" Science Environmental Science PBHE 526 Answer & Explanation Solved by verified expert Answered by petertosh Answer: C. the creation of food deserts Details. Ecologic model relating the built environment to physical activity, diet, and body weight. Glanz et al. To date, investigations of food availability within communities have primarily focused on either the spatial distribution of food stores in relation to socioeconomic characteristics of communities ( 5761 ) or the association between neighborhood food availability and individual-level dietary consumption ( 62 , 63 ). Galvez et al 65 reported that, although most built environment variables were not associated with childhood obesity in 15 studies, distance to playgrounds and density of rail stations were associated with obesity in the . Step-by-step explanation The factors that influence increases in energy consumption and decreases in energy expenditure are complex and are currently the focus of much research ( 21 , 22 ). An estimated 32% of American children are overweight, and physical inactivity contributes to this high prevalence of overweight. BMI percentile and. Trained staff measured heights and weights of all children at baseline and year 3. When investigating measures of distance, it may still be necessary to use multilevel models to adjust for area-level confounders, such as neighborhood social cohesion or socioeconomic status, which may be associated with both the distance a person has to travel to the nearest facility or food store and the person's risk of obesity. Standard definitions were used across adult populations. Both of these studies found no association. For children, this might include both school and recreational space. The built environment encompasses a range of physical and social elements that make up . The workshop examined how investments in the built environment contribute to the prevention and treatment of obesity and the overall health of communities, and it explored how to advance their effect. Cross-sectional analyses demonstrated statistically significant associations between urban sprawl and being at risk for or being overweight. Typically, studies examined either access to physical activity opportunities (i.e., proximity to play space, sidewalk availability, neighborhood walkability) ( n = 14) ( 34 , 35 , 3740 , 4244 , 4751 ) or access to food outlets (i.e., availability of fast-food restaurants, number of food stores) ( n = 4) ( 38 , 41 , 45 , 52 ); two studies ( 36 , 46 ) incorporated measures of access to both foods and physical activity within the same investigation. Two studies in adults ( 34 , 40 ) computed the distance from study participants' homes to the nearest recreational facility, with one ( 34 ) demonstrating a positive association between distance to the nearest facility and increased risk of overweight. Food availability was measured as the number of grocery stores, fast-food restaurants, convenience stores, and full-service restaurants per 1,000 persons in each child's ZIP code. The wide range of conceptualization and operationalization of measures of the built environment makes it challenging to compare results across studies. ( 44 ) used them to identify neighborhood patterns or clusters, making comparability across these studies difficult. Indices included dimensions of residential density, land-use mix, and street accessibility. Abstract. A total of 1,506 abstracts were obtained, and 20 articles met the inclusion criteria. The Surgeon General's Call to Action to Prevent and Decrease Overweight and Obesity identified action steps to prevent and/or decrease obesity as well as to modify inappropriate dietary behaviors. Self-reported height and weight were used to compute a continuous BMI variable. Search for other works by this author on: A review of cost-of-illness studies on obesity, Actual causes of death in the United States, 2000, Annual deaths attributable to obesity in the United States, Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults, NHLBI Obesity Education Initiative Expert Panel on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults, Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adultsthe evidence report, Relation of weight gain and weight loss on subsequent diabetes risk in overweight adults, Overweight children and adolescents: description, epidemiology, and demographics, Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001, Obesity: preventing and managing the global epidemic. The many theoretical pathways between the built environment and obesity have necessarily resulted in a diverse range of influences' being conceptualized and measured (see figure 1 ). Understanding the impact of the built environment on obesity may provide information necessary to develop successful community-based prevention efforts ( 29 ). British research has identified two aspects of the perceived neighborhood environment (availability of services for seniors and neighborliness) as having independent effects, net of individual characteristics, on the physical functioning of home-dwelling persons aged 65 years or older ( 89 ).
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