Inequality in the built environment underlies key health disparities in physical activity and obesity
Inequality in the built environment underlies key health disparities in physical activity and obesity
复制标题
DOI：
10.1542/peds.2005-0058
复制
发表时间：
2006-02-01
期刊：
影响因子：
8
通讯作者：
Popkin, BM
中科院分区：
文献类型：
--
作者：
Gordon-Larsen, P;Nelson, MC;Popkin, BM
上下文。环境因素被认为在身体活动(PA)和其他肥胖相关行为中起着主要作用，但还没有全国性的研究关于获得娱乐设施的差异与PA的额外影响和美国青少年超重模式之间的关系。目的：在一个具有全国代表性的队列中，我们试图评估PA设施的地理和社会分布，以及在获得娱乐设施方面的差异如何可能导致人口水平的PA和超重模式。对《全国青少年健康纵向研究》(N=20745)第一波(1994-1995)中美国青少年的居住地点进行了地理编码，并在每个住所周围画出了8.05公里的缓冲区(N=42 857个人口普查区组[美国区块组的19%])。以国家数据库和卫星数据衡量的PA设施与地理信息系统技术连接到每个答复者。Logistic回归分析检验了与PA相关的设施与社区群体的社会经济地位(SES)(在社区层面)的关系，以及随后设施与超重和PA(在个人层面)的关联，控制人口密度。结果衡量指标是超重(BMI=疾病预防控制中心/国家卫生统计中心增长曲线的第95个百分位数)和每周完成5次中等强度的PA。结果：SES较高的阻滞组拥有1个或更多设施的相对几率显著更高。低SES和高少数群体不太可能拥有设施。相对于每个街区组没有设施，设施数量的增加与超重的减少和达到每周5次中等强度PA的相对几率增加有关。结论：低SES和高少数街区组获得设施的机会减少，这反过来又与PA降低和超重增加相关。PA设施可获得性的不平等可能导致PA的种族和SES差异以及超重模式。
CONTEXT. Environmental factors are suggested to play a major role in physical activity (PA) and other obesity-related behaviors, yet there is no national research on the relationship between disparity in access to recreational facilities and additional impact on PA and overweight patterns in US adolescents.OBJECTIVE. In a nationally representative cohort, we sought to assess the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns.DESIGN, SETTING, AND PARTICIPANTS. Residential locations of US adolescents in wave I ( 1994 1995) of the National Longitudinal Study of Adolescent Health (N = 20 745) were geocoded, and a 8.05-km buffer around each residence was drawn (N = 42 857 census-block groups [19% of US block groups]). PA facilities, measured by national databases and satellite data, were linked with Geographic Information Systems technology to each respondent. Logistic-regression analyses tested the relationship of PA-related facilities with block-group socioeconomic status (SES) ( at the community level) and the subsequent association of facilities with overweight and PA ( at the individual level), controlling for population density.MAIN OUTCOME MEASURES. Outcome measures were overweight (BMI >= 95th percentile of the Centers for Disease Control and Prevention/National Center for Health Statistics growth curves) and achievement of >= 5 bouts per week of moderate-vigorous PA.RESULTS. Higher-SES block groups had a significantly greater relative odds of having 1 or more facilities. Low-SES and high-minority block groups were less likely to have facilities. Relative to zero facilities per block group, an increasing number of facilities was associated with decreased overweight and increased relative odds of achieving >= 5 bouts per week of moderate-vigorous PA.CONCLUSIONS. Lower-SES and high-minority block groups had reduced access to facilities, which in turn was associated with decreased PA and increased overweight. Inequality in availability of PA facilities may contribute to ethnic and SES disparities in PA and overweight patterns.