Neighborhood Environments and Disparities in Obesity Rates in New York City

描述（由申请人提供）：该项目将确定纽约市肥胖、久坐不动的生活方式和不良饮食的流行程度的种族/民族和社会经济差异是否可以通过纽约社区中支持体育活动（例如健身房、公园、宜人的步行环境）和健康饮食（例如杂货店、水果市场、健康食品餐馆）的社区资源差异来解释。肥胖、久坐不动的生活方式和不良的饮食习惯是2型糖尿病的主要风险因素，在纽约市，这些风险因素在非裔美国人、西班牙裔美国人和社会经济地位较低的人群中更为常见。先前在纽约市的研究表明，城市设计特征和社区社会经济地位等社区特征可以预测身体质量指数（BMI）。此外，杂货店、水果市场、快餐店、健身房和健身俱乐部的可用性在纽约市因社区而异，少数族裔和较贫穷的社区拥有较少的积极资源。这项拟议中的研究是哥伦比亚大学和纽约市健康与心理卫生部（NYCDOHMH）合作进行的。来自约45,000名纽约人的人口统计特征、体育活动、水果和蔬菜消费以及身高和体重（用于计算BMI）的访谈数据将与基于地理信息系统（GIS）的纽约市社区特征模型相结合。访谈数据和居住地的邮政编码是NYCDOHMH在2002年至2006年期间进行的五次年度全市随机数字拨号访谈的一部分，样本具有城市及其社区的代表性。GIS模型是正在进行的社区效应研究的一部分，是纽约市迄今为止建立的最全面的社区资源模型。NYCDOHMH将从食品服务许可数据库中提供额外的餐馆位置数据，从汽车中受伤的行人位置数据，以及从社区调查中获得的社区社会资本数据。社区将使用邮政编码来定义，先前的研究表明，在这个水平上，建筑和社会环境变量的变化对BMI有很强的预测作用。多层模型将用于确定社区特征在多大程度上解释了纽约市不同邮政编码的种族/民族和社会经济差异，包括BMI、身体活动和水果和蔬菜的消费。除了分析种族/民族和社会经济地位的影响外，分析还将控制年龄、性别和在美国或外国出生的身份，以及居住地邮政编码的社会人口特征。这项研究将有助于NIDDK了解2型糖尿病已知危险因素分布差异的潜在原因。此外，这些分析将用于指导纽约市正在进行的利用城市设计促进公共健康的长期规划进程。公共卫生相关性：该项目将确定纽约市肥胖、久坐不动的生活方式和不良饮食的流行程度的种族/民族和社会经济差异是否可以通过纽约社区中支持体育活动（例如健身房、公园、宜人的步行环境）和健康饮食（例如杂货店、水果市场、健康食品餐馆）的家庭社区资源差异来解释。

DESCRIPTION (provided by applicant): This project will determine whether racial/ethnic and socioeconomic disparities in the prevalence of obesity, sedentary lifestyles and poor diet in New York City are explained by disparities in neighborhood resources that support physical activity (e.g. gyms, parks, pleasant walking environments) and healthy diets (e.g. grocery stores, fruit markets, healthy food restaurants) across neighborhoods in New York. Obesity, sedentary lifestyles, and poor diets are major risk factors for the development of type 2 Diabetes and in New York City these risk factors are far more common among African Americans, Hispanics and those of lower socio-economic status. Prior research in New York City shows that neighborhood characteristics such as urban design features and neighborhood socioeconomic status predict body mass index (BMI). Furthermore, the availability of grocery stores, fruit markets, fast food restaurants, gyms and health clubs, vary by neighborhood in New York City, with minority and poorer neighborhoods having fewer positive resources. The proposed research is a collaboration between Columbia University and the New York City Department of Health and Mental Hygiene (NYCDOHMH). Interview data on demographic characteristics, physical activity, consumption of fruits and vegetables and height and weight (used to calculate BMI) from ~45,000 New Yorkers will be combined with a geographic information system (GIS) based model of the characteristics of New York City neighborhoods. The interview data and zip code of residence were collected as part of five annual citywide random digit dial interviews conducted by NYCDOHMH that occurred from 2002 to 2006, and the sample is representative of the city and its neighborhoods. The GIS model is being built as part of ongoing research on neighborhood effects and is the most comprehensive model of neighborhood resources in New York City built to date. The NYCDOHMH will contribute additional data on restaurant locations from the food service licensing database, locations of pedestrian injuries from automobiles, and neighborhood social capital from their neighborhood surveys. Neighborhoods will be defined using zip codes, and prior research has shown that variation in built and social environment variables at this level are strongly predictive of BMI. Multilevel models will be used to determine the extent to which neighborhood characteristics account for racial/ethnic and socioeconomic disparities in BMI, physical activity and consumption of fruits and vegetables across zip codes in New York City. In addition to analyzing the effects of race/ethnicity and socio-economic status the analyses will control for age, gender and U.S. or foreign born status, and the socio-demographic characteristics of the zip code of residence. This research will contribute to NIDDK's goal of understanding the underlying causes of disparities in the distribution of known risk factors for type 2 diabetes. Furthermore, the analyses will be used to guide New York City's ongoing long term planning process for using urban design to promote public health. PUBLIC HEALTH RELEVANCE: This project will determine whether racial/ethnic and socioeconomic disparities in the prevalence of obesity, sedentary lifestyles and poor diet in New York City are explained by disparities in home neighborhood resources that support physical activity (e.g. gyms, parks, pleasant walking environments) and healthy diets (e.g. grocery stores, fruit markets, healthy food restaurants) across neighborhoods in New York.