Relation between Neighborhood Environments and Obesity in the Multi-Ethnic Study of Atherosclerosis

Abstract

This study investigated associations between neighborhood physical and social environments and body mass index in 2,865 participants of the Multi-Ethnic Study of Atherosclerosis (MESA) aged 45-84 years and residing in Maryland, New York, and North Carolina. Neighborhood (census tract) environments were measured in non-MESA participants residing in MESA neighborhoods (2000-2002). The neighborhood physical environment score combined measures of a better walking environment and greater availability of healthy foods. The neighborhood social environment score combined measures of greater aesthetic quality, safety, and social cohesion and less violent crime. Marginal maximum likelihood was used to estimate associations between neighborhood environments and body mass index (kg/m(2)) before and after adjustment for individual-level covariates. MESA residents of neighborhoods with better physical environments had lower body mass index (mean difference per standard deviation higher neighborhood measure = -2.38 (95% confidence interval (CI): -3.38, -1.38) kg/m(2) for women and -1.20 (95% CI: -1.84, -0.57) kg/m(2) for men), independent of age, race/ethnicity, education, and income. Attenuation of these associations after adjustment for diet and physical activity suggests a mediating role of these behaviors. In men, the mean body mass index was higher in areas with better social environments (mean difference = 0.52 (95% CI: 0.07, 0.97) kg/m(2)). Improvement in the neighborhood physical environment should be considered for its contribution to reducing obesity.

Community Characteristics are Associated with Blood Pressure Levels in a Racially Integrated Community

“…A key finding from this study was that the directions of associations between perceived community characteristics and blood pressure levels differed in this study, compared with prior work. Prior studies used similar scales for community problems, and found it to be associated with higher blood pressure, as reviewed earlier, and other adverse physiologic outcomes such as obesity 20 and cancer. 11 Likewise, neighborhood social cohesion has not only been associated with lower rates of hypertension in studies reviewed earlier, but also with other beneficial health consequences, such as lower stroke rates.…”

“…Health behaviors and body mass index (BMI) were treated as potentially mediating variables in regression models, since obesity, lack of physical activity and smoking may be influenced by community characteristics [18][19][20] and they increase the risk of hypertension. Physical activity was categorized as never, less than three days per week, and three or more days per week based on participant report of how often they engaged in at least one hour of physical activity.…”

Area-level deprivation and adiposity in children: is the relationship linear?

“…It is reasonable therefore, to assume that the mechanisms linking obesity and area level deprivation reflect the underlying effects of deprivation on dietary habits and physical activity status. Evidence suggests that the deprivation of an area is associated with characteristics of the food (43)(44)(45)(46)(47) and physical activity environment (43,45,(48)(49)(50), with more deprived areas thought to be more obesogenic (51). Of further interest is that fact that the relationship between obesity and SES is stronger, and in many cases only shown to be statistically significant in girls.…”

Social Determinants of Risk and Outcomes for Cardiovascular Disease

“…[258][259][260] For example, a cross-sectional analysis of neighborhood factors and obesity in MESA showed that residents of neighborhoods with better walking environments and healthy food availability were more likely to have a lower BMI independently of age, race and ethnicity, education, and income. 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.…”