Neighborhood built environment and socio-economic status in relation to multiple health outcomes in adolescents

Abstract

The study aim was to examine associations of neighborhood built environment and neighborhood socio-economic status (SES) with multiple physical activity (PA) behaviors, sedentary time, and obesity indicators among adolescents. Cross-sectional study of 325 adolescents aged 14-18years recruited from schools in Valencia, Spain. Participants' home neighborhoods were classified according to walkability and SES levels. Walkability was defined as an index of three built environment characteristics (i.e., residential density, land use mix, and street connectivity) based on geographic information system data. Moderate-vigorous PA (MVPA) and sedentary time were assessed using accelerometers. Active commuting to school, leisure-time PA, and time in specific sedentary activities were evaluated by questionnaire. Objectively measured weight and height were used to calculate body mass index, and percent body fat was analyzed by bioelectrical impedance. Data were collected in 2013-15. Mixed model regression analyses were performed. Analyses showed an SES-by-walkability interaction for MVPA on weekends. MVPA was highest in high-SES/high-walkable neighborhoods. Another SES-by-walkability interaction was found for sedentary minutes per weekend day. The lowest average sedentary minutes were found in high-SES/high-walkable areas. Neighborhood SES was positively related to participation in sports teams/PA classes and, negatively to time spent in sedentary behaviors. Adolescents living in lower-SES neighborhoods spent more time watching TV and had more obesity and body fat. Present findings strengthen the rationale for targeting neighborhood built and SES environments as health promotion interventions for adolescents.

Keywords: Accelerometer; Body mass index; Exercise; Health disparities; Obesity; Physical activity; Sedentary behaviors; Walkability.