Obesity and the built environment at different urban scales: examining the literature*

Abstract

The majority of people now live in an urban (or suburban) environment. The built (material) environment, its vehicular and pedestrian infrastructure, buildings, and public realm places, are the places used for working, living, and recreating. The environment currently favors and facilitates motorized vehicles generally, and private automobiles especially. The prioritization given to vehicles reduces opportunities for other, more active modes of travel such as walking and bicycling. Though the built environment cannot be said to directly affect human obesity, the built environment clearly has a relationship to obesity as a consequence of physical activity. Most concerning is that rates of obesity have risen as cars have become increasingly privileged, leading to places that favor driving over walking or bicycling. This review examines current empirical literature on the environment and obesity at 3 key urban scales: macro, meso, and micro. Other key issues examined include longitudinal studies and self-selection bias. Evidence for a relationship between urban and suburban environments and obesity is found in the literature, but the lack of longitudinal research and research controlling for self-selection bias remains underrepresented.

Examining the Relationship between Urban Design Qualities and Walking Behavior: Empirical Evidence from Dallas, TX

“…Walking is widely known as a sustainable mode of transportation with many social, environmental, and health benefits to the individuals and the society. Numerous studies have confirmed the role of walking on reducing obesity and other chronic diseases [52], reducing greenhouse gas emissions [53], and increasing social equity and economic vitality [54]. Despite these benefits, walking mode choice is declining in most American Cities and this trend, in large part, has to do with the built environment [55].…”

Reducing the Global Burden of Cardiovascular Disease, Part 1

“…96 Availability of healthy food sources may also contribute, with studies showing less obesity in communities closer to grocery stores and more obesity in communities with more fast food restaurants or convenience stores. [95][96][97][98][99] Most studies evaluating the built environment have been cross-sectional, and therefore it is difficult to ascertain the extent to which aspects of the built environment are truly causal, or whether healthier individuals choose to live in specific environments (ie, self-selection bias). 98 Also, most data on the impact of the built environment on cardiovascular health are from HICs.…”

“…[95][96][97][98][99] Most studies evaluating the built environment have been cross-sectional, and therefore it is difficult to ascertain the extent to which aspects of the built environment are truly causal, or whether healthier individuals choose to live in specific environments (ie, self-selection bias). 98 Also, most data on the impact of the built environment on cardiovascular health are from HICs. The health impact of many aspects of the built environment may vary with context, and to date, there is a paucity of data from MICs and LICs to inform global policy.…”

Clinical Pearls for Managing Hidradenitis Suppurativa Patients of Low Socioeconomic Status

“…HS patients have been found to be 17 times more likely to be obese compared to controls [14], and obesity may play a role in disease severity [15, 16]. The immediate surrounding environment of LSES patients can contribute to weight status [17]. Neighborhoods may be less walkable due to poor infrastructure or safety concerns, and have an abundance of convenience stores and fast food establishments instead of grocery stores with fresh produce [18-20].…”