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. 2009 Mar;117(3):442-7.
doi: 10.1289/ehp.11590. Epub 2008 Oct 2.

Neighborhood food environment and walkability predict obesity in New York City

Andrew Rundle  1 , Kathryn M Neckerman, Lance Freeman, Gina S Lovasi, Marnie Purciel, James Quinn, Catherine Richards, Neelanjan Sircar, Christopher Weiss
Affiliations

Neighborhood food environment and walkability predict obesity in New York City

Andrew Rundle et al. Environ Health Perspect. 2009 Mar.

Abstract

Background: Differences in the neighborhood food environment may contribute to disparities in obesity.

Objectives: The purpose of this study was to examine the association of neighborhood food environments with body mass index (BMI) and obesity after control for neighborhood walkability.

Methods: This study employed a cross-sectional, multilevel analysis of BMI and obesity among 13,102 adult residents of New York City. We constructed measures of the food environment and walkability for the neighborhood, defined as a half-mile buffer around the study subject's home address.

Results: Density of BMI-healthy food outlets (supermarkets, fruit and vegetable markets, and natural food stores) was inversely associated with BMI. Mean adjusted BMI was similar in the first two quintiles of healthy food density (0 and 1.13 stores/km2, respectively), but declined across the three higher quintiles and was 0.80 units lower [95% confidence interval (CI), 0.27-1.32] in the fifth quintile (10.98 stores/km2) than in the first. The prevalence ratio for obesity comparing the fifth quintile of healthy food density with the lowest two quintiles combined was 0.87 (95% CI, 0.78-0.97). These associations remained after control for two neighborhood walkability measures, population density and land-use mix. The prevalence ratio for obesity for the fourth versus first quartile of population density was 0.84 (95% CI, 0.73-0.96) and for land-use mix was 0.91 (95% CI, 0.86-0.97). Increasing density of food outlets categorized as BMI-unhealthy was not significantly associated with BMI or obesity.

Conclusions: Access to BMI-healthy food stores is associated with lower BMI and lower prevalence of obesity.

Keywords: neighborhood studies; obesity; retail food environment; walkability.

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Figures

Figure 1
Figure 1
Density of BMI-healthy food outlets in New York City: Kernel Density Estimation (KDE) map illustrating the density of BMI-healthy food outlets. This KDE continuous surface was created with ArcGIS Spatial Analyst (ESRI, Redlands, CA), which uses a distance decay quadratic kernel function. Input processing parameters included a half-mile bandwidth and 1,545 discrete points representing the locations of supermarkets, fruit and vegetable markets, and natural food stores.
Figure 2
Figure 2
Adjusted mean BMI (± 95% CI) by BMI-healthy food density quintiles. Analysis is adjusted for the density of BMI-intermediate and BMI-unhealthy food outlets and for age, sex, race/ ethnicity, education, neighborhood sociodemographic characteristics, and population density.
See this image and copyright information in PMC

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