Perceived and observed neighborhood indicators of obesity among urban adults

Abstract

Objective: The global obesity epidemic has been partially attributed to modern environments that encourage inactivity and overeating, yet few studies have examined specific features of the physical neighborhood environment that influence obesity. Using two different measurement methods, this study sought to identify and compare perceived and observed neighborhood indicators of obesity and a high-risk profile of being obese and inactive. Design: Cross-sectional telephone surveys (perceived) and street-scale environmental audits (observed) were conducted concurrently in two diverse US cities to assess recreational facility access, land use, transportation infrastructure and aesthetics. Subjects: A total of 1032 randomly selected urban residents (20% obese, 32% black, 65% female). Analysis: Bivariate and multivariate logistic regression analyses were conducted to estimate the association (adjusted prevalence odds ratio (aOR)) between the primary outcome (obese vs normal weight) and perceived and observed environmental indicators, controlling for demographic variables. Results: Being obese was significantly associated with perceived indicators of no nearby nonresidential destinations (aOR ¼ 2.2), absence of sidewalks (aOR ¼ 2.2), unpleasant community (aOR ¼ 3.1) and lack of interesting sites (aOR ¼ 4.8) and observed indicators of poor sidewalk quality (aOR ¼ 2.1), physical disorder (aOR ¼ 4.0) and presence of garbage (aOR ¼ 3.7). Perceived and observed indicators of land use and aesthetics were the most robust neighborhood correlates of obesity in multivariate analyses. Conclusions: The findings contribute substantially to the growing evidence base of community-level correlates of obesity and suggest salient environmental and policy intervention strategies that may reduce population-level obesity prevalence. Continued use of both measurement methods is recommended to clarify inconsistent associations across perceived and observed indicators within the same domain.

Perception of Neighborhood Problems, Health Behaviors, and Diabetes Outcomes Among Adults With Diabetes in Managed Care

“…(It should be noted that the measures of physical activity in these studies were specific and included intensity, duration, and frequency of activity.) Further, in the one study that attempted to identify the most robust indicator of neighborhood problems, both perceived and observed neighborhood characteristics (land use patterns, reduced access to sidewalks, and aesthetic quality) were strong, robust correlates (28). Our report adds to this expanding literature by including both perceptions of neighborhood problems and objective measures of neighborhood SES as they relate to several measured outcomes among individuals with an established chronic disease such as diabetes.…”

Environmental Audits of Friendliness toward Physical Activity in Three Income Levels

“…Moreover, perceived and objective measures of the environment may be differently associated with physical activity. 31,37 Additionally, it may be useful to distinguish between recreational and utilitarian physical activities and the unique factors and features associated with each. 18,31 We did not measure the age of housing for each block group in the three income levels.…”

Social Determinants of Risk and Outcomes for Cardiovascular Disease

“…261 Other studies also have shown associations of neighborhood walkability and density of fast-food restaurants with obesity prevalence and blood pressure. 262,263 An Australian study found that exposure to energy-dense snack foods and soft drinks in supermarkets was greater in socioeconomically disadvantaged neighborhoods. This may affect purchasing, consumption, and cultural norms related to eating behaviors.…”