Built Environment and Weight Disparities Among Children in High- and Low-Income Towns

Objective To assess differences in built environment and child weight, and associations between them in high- and low-income communities. Methods By means of cross-sectional clinical and demographic data for children aged 2 to 18 years from an integrated health system in Massachusetts, we linked sub...

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Published in:Academic pediatrics 2009-09, Vol.9 (5), p.315-321
Main Authors: Oreskovic, Nicolas M., MD, MPH, Kuhlthau, Karen A., PhD, Romm, Diane, PhD, Perrin, James M., MD
Format: Article
Language:English
Subjects:
Adolescent
built environment
Child
Child, Preschool
Cohort Studies
communities
Cross-Sectional Studies
disparities
Environment Design
fast food
Female
GIS
Health Status Disparities
Humans
Income
Male
Massachusetts
Neonatal and Perinatal Medicine
obesity
Obesity - epidemiology
pediatric
Pediatrics
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cited_by cdi_FETCH-LOGICAL-c410t-ccceac322fe4a892cf6ebb9d33b2ed70a0a762fe1377e62816391c8159cf6c063
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container_start_page 315
container_title Academic pediatrics
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creator Oreskovic, Nicolas M., MD, MPH
Kuhlthau, Karen A., PhD
Romm, Diane, PhD
Perrin, James M., MD
description Objective To assess differences in built environment and child weight, and associations between them in high- and low-income communities. Methods By means of cross-sectional clinical and demographic data for children aged 2 to 18 years from an integrated health system in Massachusetts, we linked subject (n = 6680) and spatial data from Geographic Information Systems. We selected towns with at least 100 subjects per town (n = 46 towns), and we divided towns into quartiles by household income. We compared highest and lowest quartile towns on environmental characteristics (density of fast food restaurants, distance to nearest fast food restaurant, distance to nearest age-appropriate school) and overweight and obesity prevalence. We used clustered logistic regression to assess for associations between environmental characteristics and weight and carried out similar analyses stratified by age (2 to
doi_str_mv 10.1016/j.acap.2009.02.009
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Methods By means of cross-sectional clinical and demographic data for children aged 2 to 18 years from an integrated health system in Massachusetts, we linked subject (n = 6680) and spatial data from Geographic Information Systems. We selected towns with at least 100 subjects per town (n = 46 towns), and we divided towns into quartiles by household income. We compared highest and lowest quartile towns on environmental characteristics (density of fast food restaurants, distance to nearest fast food restaurant, distance to nearest age-appropriate school) and overweight and obesity prevalence. We used clustered logistic regression to assess for associations between environmental characteristics and weight and carried out similar analyses stratified by age (2 to &lt;5, 5 to &lt;12, 12 to 18 years). Results Low-income towns had more sidewalks, less open space, a greater density of fast food restaurants, and higher rates of overweight/obesity. Among low-income-town children, after adjusting for age, gender, race, and town, density of fast food restaurants was positively associated with overweight and obesity, whereas distance to nearest age-appropriate school and fast food restaurant were inversely associated with obesity. Children from low-income towns appeared to have more consistent associations between weight status and the built environment. Conclusions Built environment varies by town income. Children living in low-income towns tend to have built environments that promote energy intake and decrease opportunities for energy expenditure.</description><identifier>ISSN: 1876-2859</identifier><identifier>EISSN: 1876-2867</identifier><identifier>DOI: 10.1016/j.acap.2009.02.009</identifier><identifier>PMID: 19477705</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; built environment ; Child ; Child, Preschool ; Cohort Studies ; communities ; Cross-Sectional Studies ; disparities ; Environment Design ; fast food ; Female ; GIS ; Health Status Disparities ; Humans ; Income ; Male ; Massachusetts ; Neonatal and Perinatal Medicine ; obesity ; Obesity - epidemiology ; pediatric ; Pediatrics</subject><ispartof>Academic pediatrics, 2009-09, Vol.9 (5), p.315-321</ispartof><rights>Academic Pediatric Association</rights><rights>2009 Academic Pediatric Association</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c410t-ccceac322fe4a892cf6ebb9d33b2ed70a0a762fe1377e62816391c8159cf6c063</citedby><cites>FETCH-LOGICAL-c410t-ccceac322fe4a892cf6ebb9d33b2ed70a0a762fe1377e62816391c8159cf6c063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19477705$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Oreskovic, Nicolas M., MD, MPH</creatorcontrib><creatorcontrib>Kuhlthau, Karen A., PhD</creatorcontrib><creatorcontrib>Romm, Diane, PhD</creatorcontrib><creatorcontrib>Perrin, James M., MD</creatorcontrib><title>Built Environment and Weight Disparities Among Children in High- and Low-Income Towns</title><title>Academic pediatrics</title><addtitle>Acad Pediatr</addtitle><description>Objective To assess differences in built environment and child weight, and associations between them in high- and low-income communities. Methods By means of cross-sectional clinical and demographic data for children aged 2 to 18 years from an integrated health system in Massachusetts, we linked subject (n = 6680) and spatial data from Geographic Information Systems. We selected towns with at least 100 subjects per town (n = 46 towns), and we divided towns into quartiles by household income. We compared highest and lowest quartile towns on environmental characteristics (density of fast food restaurants, distance to nearest fast food restaurant, distance to nearest age-appropriate school) and overweight and obesity prevalence. We used clustered logistic regression to assess for associations between environmental characteristics and weight and carried out similar analyses stratified by age (2 to &lt;5, 5 to &lt;12, 12 to 18 years). Results Low-income towns had more sidewalks, less open space, a greater density of fast food restaurants, and higher rates of overweight/obesity. Among low-income-town children, after adjusting for age, gender, race, and town, density of fast food restaurants was positively associated with overweight and obesity, whereas distance to nearest age-appropriate school and fast food restaurant were inversely associated with obesity. Children from low-income towns appeared to have more consistent associations between weight status and the built environment. Conclusions Built environment varies by town income. Children living in low-income towns tend to have built environments that promote energy intake and decrease opportunities for energy expenditure.</description><subject>Adolescent</subject><subject>built environment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Cohort Studies</subject><subject>communities</subject><subject>Cross-Sectional Studies</subject><subject>disparities</subject><subject>Environment Design</subject><subject>fast food</subject><subject>Female</subject><subject>GIS</subject><subject>Health Status Disparities</subject><subject>Humans</subject><subject>Income</subject><subject>Male</subject><subject>Massachusetts</subject><subject>Neonatal and Perinatal Medicine</subject><subject>obesity</subject><subject>Obesity - epidemiology</subject><subject>pediatric</subject><subject>Pediatrics</subject><issn>1876-2859</issn><issn>1876-2867</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNp9kU9v1DAQxS0Eon_gC3BAvnFKGNtZO5YQUlkKrbRSD23F0fI6s62XxF7spFW_fR12BRIHTm-k-b0nzRtC3jGoGTD5cVtbZ3c1B9A18LrIC3LMWiUr3kr18s-80EfkJOctgBRtK1-TI6YbpRQsjsntl8n3Iz0PDz7FMGAYqQ0d_YH-7n6kX33e2eRHj5meDTHc0eW977uEgfpALwpT_cZX8bG6DC4OSG_iY8hvyKuN7TO-Pegpuf12frO8qFZX3y-XZ6vKNQzGyjmH1gnON9jYVnO3kbhe606INcdOgQWrZFkyoRRK3jIpNHMtW-hCunLNKfmwz92l-GvCPJrBZ4d9bwPGKRslGmi0bkUh-Z50KeaccGN2yQ82PRkGZm7TbM3cppnbNMBNkWJ6f4if1gN2fy2H-grwaQ9gOfLBYzLZeQwOO5_QjaaL_v_5n_-xu94H72z_E58wb-OUQqnPMJOLwVzP_5zfCRoAFkqKZ0sUmoY</recordid><startdate>20090901</startdate><enddate>20090901</enddate><creator>Oreskovic, Nicolas M., MD, MPH</creator><creator>Kuhlthau, Karen A., PhD</creator><creator>Romm, Diane, PhD</creator><creator>Perrin, James M., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20090901</creationdate><title>Built Environment and Weight Disparities Among Children in High- and Low-Income Towns</title><author>Oreskovic, Nicolas M., MD, MPH ; Kuhlthau, Karen A., PhD ; Romm, Diane, PhD ; Perrin, James M., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c410t-ccceac322fe4a892cf6ebb9d33b2ed70a0a762fe1377e62816391c8159cf6c063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adolescent</topic><topic>built environment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Cohort Studies</topic><topic>communities</topic><topic>Cross-Sectional Studies</topic><topic>disparities</topic><topic>Environment Design</topic><topic>fast food</topic><topic>Female</topic><topic>GIS</topic><topic>Health Status Disparities</topic><topic>Humans</topic><topic>Income</topic><topic>Male</topic><topic>Massachusetts</topic><topic>Neonatal and Perinatal Medicine</topic><topic>obesity</topic><topic>Obesity - epidemiology</topic><topic>pediatric</topic><topic>Pediatrics</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Oreskovic, Nicolas M., MD, MPH</creatorcontrib><creatorcontrib>Kuhlthau, Karen A., PhD</creatorcontrib><creatorcontrib>Romm, Diane, PhD</creatorcontrib><creatorcontrib>Perrin, James M., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Academic pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Oreskovic, Nicolas M., MD, MPH</au><au>Kuhlthau, Karen A., PhD</au><au>Romm, Diane, PhD</au><au>Perrin, James M., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Built Environment and Weight Disparities Among Children in High- and Low-Income Towns</atitle><jtitle>Academic pediatrics</jtitle><addtitle>Acad Pediatr</addtitle><date>2009-09-01</date><risdate>2009</risdate><volume>9</volume><issue>5</issue><spage>315</spage><epage>321</epage><pages>315-321</pages><issn>1876-2859</issn><eissn>1876-2867</eissn><abstract>Objective To assess differences in built environment and child weight, and associations between them in high- and low-income communities. Methods By means of cross-sectional clinical and demographic data for children aged 2 to 18 years from an integrated health system in Massachusetts, we linked subject (n = 6680) and spatial data from Geographic Information Systems. We selected towns with at least 100 subjects per town (n = 46 towns), and we divided towns into quartiles by household income. We compared highest and lowest quartile towns on environmental characteristics (density of fast food restaurants, distance to nearest fast food restaurant, distance to nearest age-appropriate school) and overweight and obesity prevalence. We used clustered logistic regression to assess for associations between environmental characteristics and weight and carried out similar analyses stratified by age (2 to &lt;5, 5 to &lt;12, 12 to 18 years). Results Low-income towns had more sidewalks, less open space, a greater density of fast food restaurants, and higher rates of overweight/obesity. Among low-income-town children, after adjusting for age, gender, race, and town, density of fast food restaurants was positively associated with overweight and obesity, whereas distance to nearest age-appropriate school and fast food restaurant were inversely associated with obesity. Children from low-income towns appeared to have more consistent associations between weight status and the built environment. Conclusions Built environment varies by town income. Children living in low-income towns tend to have built environments that promote energy intake and decrease opportunities for energy expenditure.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>19477705</pmid><doi>10.1016/j.acap.2009.02.009</doi><tpages>7</tpages></addata></record>
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subjects Adolescent
built environment
Child
Child, Preschool
Cohort Studies
communities
Cross-Sectional Studies
disparities
Environment Design
fast food
Female
GIS
Health Status Disparities
Humans
Income
Male
Massachusetts
Neonatal and Perinatal Medicine
obesity
Obesity - epidemiology
pediatric
Pediatrics
title Built Environment and Weight Disparities Among Children in High- and Low-Income Towns
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