Neighborhood Disorder and Obesity-Related Outcomes among Women in Chicago

Abstract

Neighborhood psychosocial stressors like crime and physical disorder may influence obesity-related outcomes through chronic stress or through adverse effects on health behaviors. Google Street View imagery provides a low-cost, reliable method for auditing neighborhood physical disorder, but few studies have examined associations of Street View-derived physical disorder scores with health outcomes. We used Google Street View to audit measures of physical disorder for residential census blocks from 225 women aged 18–44 enrolled from 4 Chicago neighborhoods. Latent neighborhood physical disorder scores were estimated using an item response theory model and aggregated to the block group level. Block-group level physical disorder scores and rates of police-recorded crime and 311 calls for service requests were linked to participants based on home addresses. Associations were estimated for 6 obesity-related outcomes: body mass index, obesity, total moderate-to-vigorous physical activity, and weekly consumption of sugar-sweetened beverages, fast food, and snacks. Hierarchical regression models estimated cross-sectional associations adjusting for individual sociodemographics and neighborhood poverty. Higher neighborhood physical disorder was associated with greater odds of obesity (OR: 1.43, 95% CI: 1.01, 2.02). Living in a neighborhood with a higher crime rate was associated with an increase in weekly snack consumption of 3.06 (95% CI: 1.59, 4.54).

Neighborhood Social Environment and Cardiovascular Disease Risk

“…remain understudied with respect to their relationship with CVD risk. However, both have been demonstrated to associate with PA [59•-61] and weight status [62, 63, 52•].…”

“…For example, a recent longitudinal study found a negative relationship between neighborhood disorder and scores on the Physical Activity Scale for the Elderly (PASE, mean difference=−2.0 units in PASE score [95% C.I.=−3.6, −0.3]) at baseline, but no association between disorder and PASE score after 2 years of follow up [60]. In contrast, a cross-sectional study examining the association between physical disorder (based on 311 complaint reports) and BMI indicated no association between them [62].…”

“…One limitation of recent work exploring social cohesion and disorder is that many of the survey items used to measure cohesion and disorder may not be specific enough to be correlated to PA outcomes. In addition, many of these studies only assessed single cities, which reduced the generalizability of the study findings to different areas of the U.S. [62, 60]. In future studies, researchers should attempt to develop more validated survey instruments to measure cohesion and disorder and should perform research across multiple U.S. cities to further clarify the role of social cohesion and disorder in CVD risk.…”

“…Assessing neighborhood social environment through audit tools (i.e., evaluating the quality and presence/absence of specific environmental features at a certain street segment such as presence and condition of sidewalks, litters, graffiti on a wall) [78] requires trained observers and can be time-consuming. Despite this, researchers have still employed this technique to comprehensively evaluate neighborhood quality [79-81, 62]. Recently, some studies have begun to conduct such audits digitally using tools such as Google Street View.…”

“…Recently, some studies have begun to conduct such audits digitally using tools such as Google Street View. Mayne and colleagues used Google Street View audits to assign physical disorder scores to census blocks in four Chicago neighborhoods and subsequently examined associations of physical disorder scores with PA, BMI, and obesity [62]. They found that neighborhood physical disorder was positively associated with obesity (odds ratio=1.43 [95% C.I.=1.01, 2.02]) [62].…”