Investigating the Association between Built Environment, Race, and Childhood Obesity
Abstract
Introduction and Objective. In the US, obesity is a major concern with multiple comorbidities, primarily linked to physical inactivity and poor nutrition. The built environment, encompassing accessibility, walkability, and more, may influence these risk factors and obesity rates. While the built environment's link to obesity is well-established in adults, it is less studied in children. Moreover, less is known about whether this relationship between built environment and obesity varies by race/ethnicity. This study aims to examine the connection between the built environment and childhood obesity and whether this association varies by race/ethnicity. Methods. This cross-sectional study utilized data from the 2019 National Survey of Children's Health to investigate the association between built environment and childhood obesity in children aged 10-17. We excluded children with unspecified races or BMI ≤ 5th percentile. The exposure was a built environment score based on walkability, park/playground accessibility, safety, and recreational centers, while the outcome was BMI status (overweight/obese vs. normal weight). Descriptive analysis assessed baseline characteristics. A bivariate analysis was conducted to identify associations between these baseline characteristics and both exposure and outcomes. A multiple logistic regression model controlled for confounders and examined potential race/ethnicity-related effect modification in the built environment-childhood obesity relationship. Results. We evaluated a total of 13684 responses. The odds of being overweight or obese in childhood were 25% higher in a poor environment (OR = 1.25; 95% CI 1.03-1.52). After accounting for confounders, the association between childhood obesity and a poor environment diminished and lost statistical significance (aOR= 1.19; 95% CI 0.95-1.48). Minority status, financial difficulty, parents with high school education or less, physical inactivity, and having one or more comorbidities were linked to higher odds of childhood overweight/obesity status. The effect modification of race/ethnicity showed similar ORs with overlapping confidence intervals. Conclusions-Implications. While our study found no significant association between the built environment and childhood obesity, it's crucial to note limitations due to our reliance on survey data based on parental reports rather than objective data. Future research should collect objective data and individually assess each built environment feature, incorporating standardized criteria.
Keywords
built environment, childhood obesity, race/ethnicity
Presentation Type
Oral Presentation
Investigating the Association between Built Environment, Race, and Childhood Obesity
Introduction and Objective. In the US, obesity is a major concern with multiple comorbidities, primarily linked to physical inactivity and poor nutrition. The built environment, encompassing accessibility, walkability, and more, may influence these risk factors and obesity rates. While the built environment's link to obesity is well-established in adults, it is less studied in children. Moreover, less is known about whether this relationship between built environment and obesity varies by race/ethnicity. This study aims to examine the connection between the built environment and childhood obesity and whether this association varies by race/ethnicity. Methods. This cross-sectional study utilized data from the 2019 National Survey of Children's Health to investigate the association between built environment and childhood obesity in children aged 10-17. We excluded children with unspecified races or BMI ≤ 5th percentile. The exposure was a built environment score based on walkability, park/playground accessibility, safety, and recreational centers, while the outcome was BMI status (overweight/obese vs. normal weight). Descriptive analysis assessed baseline characteristics. A bivariate analysis was conducted to identify associations between these baseline characteristics and both exposure and outcomes. A multiple logistic regression model controlled for confounders and examined potential race/ethnicity-related effect modification in the built environment-childhood obesity relationship. Results. We evaluated a total of 13684 responses. The odds of being overweight or obese in childhood were 25% higher in a poor environment (OR = 1.25; 95% CI 1.03-1.52). After accounting for confounders, the association between childhood obesity and a poor environment diminished and lost statistical significance (aOR= 1.19; 95% CI 0.95-1.48). Minority status, financial difficulty, parents with high school education or less, physical inactivity, and having one or more comorbidities were linked to higher odds of childhood overweight/obesity status. The effect modification of race/ethnicity showed similar ORs with overlapping confidence intervals. Conclusions-Implications. While our study found no significant association between the built environment and childhood obesity, it's crucial to note limitations due to our reliance on survey data based on parental reports rather than objective data. Future research should collect objective data and individually assess each built environment feature, incorporating standardized criteria.