Place matters: USC research uncovers the strongest predictor of childhood and adolescent obesity
The physical spaces where kids live, play and learn have the biggest impact on obesity status and eating behaviors, according to USC research.
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Neighborhood design, walkability and access to healthy food outlets, parks and green spaces are the strongest environmental predictors of obesity and eating behaviors in children and adolescents, according to a new USC study published today in the journal Obesity.
“Past studies have focused on the built, social and economic environments simultaneously, but have not assessed the independent roles that each play in influencing health,” said study author Maria Prados, an economist at the USC Dornsife College of Letters, Arts and Sciences’ Center for Economic and Social Research (CESR). “The findings add a new dimension to the growing evidence that place matters by applying a more comprehensive approach to characterizing environment.”
The quality of a neighborhood’s built environment often goes hand in hand with its social (e.g., crime, population characteristics, norms) and economic (e.g., unemployment rates, household income) environments. Researchers wanted to isolate those qualities in hopes of identifying more precise interventions for childhood and adolescent obesity.
Healthy environments make for healthier kids
To assess the effects of the built environment on obesity and eating behaviors, Prados and her team analyzed data from the Military Teenagers’ Environments, Exercise, and Nutrition Study (M-TEENS), a cohort study of adolescents in military families in different geographic locations, both on military bases and in surrounding communities. Because military families are routinely assigned to specific installations for reasons beyond their control, the variation in environments across families provided researchers with a way to quantify the impacts of place on childhood and adolescent obesity.
M-TEENS collected data on BMI, overweight and obesity status, and self-reported diet and exercise from a sample of 1,111 adolescents ages 12-14.
The researchers created index scores to grade the healthfulness of county-level built, economic and social environments, a metric based on the opportunities available for individuals to engage in healthy behaviors. Higher values imply more advantageous environments.
Results showed that living in counties with higher built environment scores for more than two years was associated with lower likelihood of obesity. These “healthier” environments were also associated with lower consumption of unhealthy foods.
In counties with a built environment score at the 25th percentile — compared to a county at the 75th percentile — the risk of adolescent obesity was 3.6 percentage points higher after more than two years of exposure. The results were similar for adolescents in military families not living on military bases, thus more exposed to the surrounding communities.
Findings from the study can be used to inform targeted public health interventions to reduce obesity and promote healthy eating behaviors in children and adolescents.
“Adolescents represent an important target for potential health policy interventions because they are at an age when their health behaviors, preferences and interactions with the environments are evolving,” the authors said. “Improving built environments may provide the most promising opportunities to address overweight and obesity among adolescents.”
About the study
Co-authors of the study include Ashlesha Datar, senior economist and director of the Program on Children and Families at CESR, and Nancy Nicosia of the Rand Corporation.
The research was funded by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health under award number R01DK111169.