The influence of the built environment, social environment and health behaviors on body mass index. Results from RESIDE
Research highlights
► BMI not associated with objective measures of built environment. ► BMI negatively associated with perceived safety from crime. ► Built environment factors that limit physical activity warrant further exploration.
Introduction
Obesity is a major public health concern worldwide. Interest in the relationship between the built environment and obesity is growing (Papas et al., 2007), partly because environmental modifications could have sustained population impact (Sallis et al., 2006). Individual socio-demographic (Ball and Crawford, 2005) and social environment (e.g., overweight partner, low social support for physical activity and healthy eating) (Cohen et al., 2006) factors are consistently associated with body mass index (BMI). Positive associations with fast food outlets and convenience stores, and inverse associations with grocery stores, supermarkets and recreation facilities (Holsten, 2009, Robertson-Wilson and Giles-Corti, 2010) and neighborhood walkability (Doyle et al., 2006, Frank et al., 2006, Saelens et al., 2003) have been reported.
Few studies have tested a comprehensive model of correlates of adult BMI or examined the relative influence of individual, social and built environment factors (Robertson-Wilson and Giles-Corti, 2010). This study examined individual, behavioral, social and built environment correlates of BMI in Australian adults.
Section snippets
Sample
Data were from baseline measures on 1551 participants in the RESIDential Environments project (RESIDE) (Giles-Corti et al., 2008). Participants were adults building a new home in a new housing development who completed a survey prior to moving in (baseline residential locations were distributed throughout metropolitan Perth). Ethics approval was provided by The University of Western Australia's Human Research Ethics Committee.
Measures
BMI (kg/m2) was calculated using self-report height and weight.
Results
Six of the 14 individual factors examined were significantly associated with BMI (Table 1) and collectively explained 3.3% of the variance in BMI.
Table 2 shows associations between each behavioral, social and built environment measure and BMI, adjusted for socio-demographic factors. All 3 health behavior variables were significantly related to BMI, explaining an additional 2.7% of the variance in BMI. None of the objective measures of the built environment—including the presence or density of
Discussion
In this study, age, gender, household composition, education, hours worked, total physical activity, leisure-time sedentary behavior, saturated fat consumption, and perceived safety from crime were significantly associated with BMI. The social environment and objective built environment measures were not associated with BMI. Estimated effect sizes for physical activity and the total variance explained by the models were small. This may be due to the cross-sectional study design and reliance on
Conclusions
Few built environment factors were associated with BMI in this study. However, greater perceived safety from crime was associated with lower BMI, and this association persisted after controlling for socio-demographic factors and obesity-related health behaviors. Future research should examine mediating pathways between the built and social environments, behavior and BMI and incorporate longitudinal designs.
Conflict of interest statement
No conflict of interest was reported by the authors of this paper.
Acknowledgments
This research was funded by a Western Australian Health Promotion Foundation (Healthway) (#11828) and an Australian Research Council (ARC) Linkage grant (#LPO455453). The Western Australian Land Information Authority (© 2003), Western Australian Department of Planning and Sensis Pty Ltd provided spatial data for the objective built environment measures. Hayley Christian and Sarah Foster are supported by an NHMRC Population Health Capacity Building Grant (#458668), Billie Giles-Corti is
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