Associations between Walkability and Youth Obesity: Differences by Urbanicity

Abstract

Background: Attributes of the built environment, such as neighborhood walkability, have been linked to increased physical activity and reduced obesity risk. This relationship, however, has primarily been documented in adults; less is known about neighborhood walkability and youth obesity, as limited prior research has produced mixed findings. The purpose of this study was to examine the association between neighborhood walkability and youth obesity, including differences by urbanicity. Methods: Data were collected in 2013 from youth aged 7-14 years (n = 13,469) in a Southeastern county school district. Height and weight were objectively measured and utilized to calculate body mass index (BMI) z-scores. Youth demographic characteristics and addresses were obtained, and a Walk Score Ò was gathered for each youth's home address. Multilevel linear regression analysis, accounting for nesting within census block groups, was conducted to examine the association between Walk Score and BMI z-score and to test for the moderating effect of urbanicity. Separate multilevel analyses examined Walk Score and BMI z-score among urban, urban-rural mixed, and rural youth subsamples. Results: Overall, as Walk Score increased, youth BMI z-score decreased. Walk Score was positively associated with BMI z-score among urban youth and negatively associated with BMI z-score among rural youth; no relationship was observed between Walk Score and youth in urban-rural mixed areas. Conclusions: Neighborhood walkability may impact youth differently across geographic areas. Further study is warranted about how youth utilize a walkable environment and mechanisms through which walkability influences youth physical activity and obesity risk.

The built environment as determinant of childhood obesity: A systematic literature review

“…The three main components of the walkability index (land use mix, street connectivity, and net residential density) were often individually analyzed. Two studies used the Walk Score, 37,45 a web‐based tool (http://www.walkscore.com) that relies mainly on the distance to various amenities and includes population density and road metrics such as block length and intersection density. One study adopted a different approach by deriving a walkability index composed of land use mix, sidewalks, sidewalk buffers, sidewalk/street lighting, other sidewalk elements, traffic lights, pedestrian signal at traffic lights, marked crosswalks, pedestrian crossing, and other signage and public transport 46 .…”

Walkability indices and childhood obesity: A review of epidemiologic evidence

“…For example, although the walkability score (e.g., intersection density and land use mix) was calculated and identified as positively correlated with PA among children in Spain, 25,27 Australia, 26 the United States 31,32 and New Zealand, 29 this correlation was not found in two other studies conducted in Scotland 30 and Germany 33 . Furthermore, the correlation between walkability scores and obesity is far from conclusive: Although the negative correlation between walkability scores and the childhood obesity index (e.g., BMI) was found to be significant in the United States 34,35 and Malaysia, 36 this correlation was not significant in Germany 37 . In addition, one study showed that the walkability score was positively associated with the risk of overweight or obesity in England 38 …”

Adolescent Brain Cognitive Development (ABCD) study Linked External Data (LED): Protocol and practices for geocoding and assignment of environmental data

“…Urbanicity indices may reflect the presence of environmental and social conditions that are more common in urban areas, such as pollution, congestion, and increased rates of social interactions. To date, various health factors have been linked to urbanicity, such as increases in overweight/obesity, increased calorie intake, decreased physical activity, increased drug and alcohol use, and mental health disorders, among many others ( Evans et al, 2020 , Rudolf et al, 2014 ; Stowe et al 2019 ). In the ABCD Study, we have linked five measures of urbanicity to residential addresses, including two density measures (population and gross residential), census-tract derived metrics classifying the locations as urban or non-urban areas, walkability, and motor vehicle information including distance to roadway and traffic volumes.…”