Association of neighborhood built environments with childhood obesity: Evidence from a 9-year longitudinal, nationally representative survey in the US

Peng Jia · Hong Xue · Xi Cheng · Yaogang Wang

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Urban Transport and Accessibility Obesity, Physical Activity, Diet Urban Green Space and Health

Abstract

BACKGROUND: The built environment is an important contributor to childhood obesity; however, large-scale and longitudinal studies designed to examine their associations remain limited. This study aimed to examine whether walkable neighborhoods were associated with childhood obesity risk over a 9-year period. METHODS: We used data collected in the US nationally representative Early Childhood Longitudinal Study - Kindergarten (ECLS-K) Cohort, with 9440 kindergarteners followed up until their 8th grade (1998-2007). Four built environmental variables, street intersection density, residential density, fitness facility density, and recreational facility density, were calculated from national census, business, and road network datasets, and then matched with ECLS-K samples. Mixed-effect models were performed to estimate associations between built environments and child weight status. RESULTS: Children who experienced increased intersection density during 1998-2007 had a lower BMI in 2007 (β = -0.49, p < 0.01), especially girls (β = -0.79, p < 0.01) and suburban children (β = -0.66, p < 0.05). They also had lower obesity risk in 2007 (OR = 0.79 [95% CI = 0.66-0.94]), especially girls (OR = 0.68 [95% CI = 0.52-0.88]). Girls and boys who lived in neighborhoods with the higher (but not highest) residential density in 1998 showed lower obesity risk (OR = 0.54 [95% CI = 0.30-0.98]) and overweight risk (OR = 0.54 [95% CI = 0.30-0.95]) in 2007, respectively. CONCLUSIONS: National data indicate that in the US greater walkability in residential neighborhoods may lead to lower child BMI and obesity risk after nine years, and the association was stronger among girls and in suburban regions. This provides useful evidence for future obesity prevention and urban planning.

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References

2006Inequality in the Built Environment Underlies Key Health Disparities in Physical Activity and Obesity 2009Measuring the Built Environment for Physical Activity 2011A systematic review of built environment factors related to physical activity and obesity risk: implications for smart growth urban planning 2011Validation of Walk Score® for Estimating Neighborhood Walkability: An Analysis of Four US Metropolitan Areas 2007Does Residential Density Increase Walking and Other Physical Activity?2007The Urban Built Environment and Obesity in New York City: A Multilevel Analysis 2014Characteristics of Walkable Built Environments and BMI z -Scores in Children: Evidence from a Large Electronic Health Record Database 2011Body Mass Index and the Built and Social Environments in Children and Adolescents Using Electronic Health Records

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2019Spatial Lifecourse Epidemiology Reporting Standards (ISLE-ReSt) statement 2020Traffic‐related environmental factors and childhood obesity: A systematic review and meta‐analysis 2019Street connectivity, physical activity, and childhood obesity: A systematic review and meta‐analysis 2020Walkability indices and childhood obesity: A review of epidemiologic evidence

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