Dataset Information

Neighborhood sidewalk access and childhood obesity.

ABSTRACT: The lack of access to sidewalks is a barrier for physical activity (PA) and may be a risk factor for childhood obesity. However, previous studies reported mixed findings and the association between sidewalk accessibility and childhood obesity remains unclear. This study systematically examined the evidence on the association between sidewalk accessibility and childhood obesity. PubMed, Cochrane Library, and Web of Science were searched for relevant articles (published before 1 January 2019) that reported on the association between neighborhood sidewalk access and weight-related behaviors and outcomes in children. Seventeen studies conducted in five countries were included. Ten studies used objective measure of access to sidewalks, seven studies measured children's height and weight, and seven studies objectively measured the PA or sedentary behaviors. Ten studies reported on the association of better access to sidewalks with increased PA (β ranging from 0.032 to 2.159; p < 0.05), reduced sedentary behaviors (β ranging from -0.19 to -0.14; p < 0.05), lower body mass index (BMI) (β ranging from -0.261 to -0.144; p < 0.001), or obesity risks (OR ranging from 1.02 to 1.32; p < 0.05); while the remaining seven studies did not report a desirable obesity-sidewalk association. Our findings support the hypothesis that higher sidewalk accessibility is associated with higher PA levels, lower BMI, and obesity risks. Efforts in building healthy environments, including health-promoting city planning, can help minimize the growing obesity epidemic and promote public health.

SUBMITTER: Wei J

PROVIDER: S-EPMC7988567 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Neighborhood sidewalk access and childhood obesity.

Wei Junxiang J Wu Yang Y Zheng Jinge J Nie Peng P Jia Peng P Wang Youfa Y

Obesity reviews : an official journal of the International Association for the Study of Obesity 20200707

The lack of access to sidewalks is a barrier for physical activity (PA) and may be a risk factor for childhood obesity. However, previous studies reported mixed findings and the association between sidewalk accessibility and childhood obesity remains unclear. This study systematically examined the evidence on the association between sidewalk accessibility and childhood obesity. PubMed, Cochrane Library, and Web of Science were searched for relevant articles (published before 1 January 2019) that ...[more]

PMID: 32638457

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Project description:ImportanceChildhood obesity is a principal public health concern. Understanding the geographic distribution of childhood obesity can inform the design and delivery of interventions.ObjectiveTo better understand the causes of spatial dependence in rates of childhood obesity across neighborhoods.Design, setting, and participantsThis cohort study used data from a legislatively mandated body mass index screening program for public school children in Arkansas from the 2003-2004 through 2014-2015 academic years. Spatial autoregressive moving average (SARMA) models for panel data were used to estimate spatial dependency in childhood obesity at 2 levels of spatial aggregation. Data were analyzed from August 2017 to February 2018.ExposuresThe SARMA models included geographic fixed effects to capture time-invariant differences in neighborhood characteristics along with controls for the mean age of children and the proportion of children by race/ethnicity, school meal status, and sex.Main outcomes and measuresThe proportion of obese schoolchildren in Arkansas neighborhoods by year, defined at larger (census tract) and smaller (census block group) spatial scales.ResultsThe geographic aggregations were based on 935 800 children with a mean (SD) age of 132 (39) months. Of these children, 51% were male; 65% were white, 21% were black, 10% were Hispanic, 2% were Asian, and the remainder were of other or unidentified race/ethnicity. In models without geographic fixed effects, there was evidence of positive and significant spatial autocorrelation in obesity rates across tracts (ρ = 0.511; 95% CI, 0.469-0.553) and block groups (ρ = 0.569; 95% CI, 0.543-0.595). When geographic fixed effects were included, spatial autocorrelation diminished at the census tract level (ρ = 0.271; 95% CI, 0.147-0.396) and disappeared at the census block group level (ρ = -0.075; 95% CI, -0.264 to 0.114).Conclusions and relevanceBecause block groups are smaller than tracts, children in neighboring block groups were more likely to attend the same schools and interact through neighborhood play. Thus, geographic-based social networks were more likely to span block group boundaries. The lack of evidence of spatial autocorrelation in block group-level models suggests that social contagion may be less important than differences in neighborhood context across space. Caution should be used in interpreting significant spatial autocorrelation as evidence of social contagion in obesity.

Dataset Information

Neighborhood sidewalk access and childhood obesity.

Publications

Neighborhood sidewalk access and childhood obesity.

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