Underserved Communities Have the Highest Need for Built Environment Interventions Targeting Obesity
Year: 2009
Type: letter
Abstract: Grafova et al. provide insightful analysis on the relationship between neighborhoods and obesity in older adults in the United States. According to them, neighborhood economic advantage protected against overweight and obesity, and economic disadvantage increased the likelihood of overweight and obesity in older men and women.1 Recently, there is increased interest in how the built environment2 influences both sides of the energy balance equation: food intake and energy expenditure. New research underscores the effect the built environment has on health outcomes such as access to healthful foods and physical activity. Grafova et al. suggest that interventions targeting the built environment in economically disadvantaged communities have the potential to improve poor health outcomes.1 One such intervention, targeting pediatric obesity, was unique and successful because it included changes to the built environment such as farmer's market initiatives and city ordinances promoting walking and biking.3 Another intervened at the level of food stores in American Indian reservations by introducing and promoting healthful foods.4 These studies exemplify the healthful role that built environment interventions can play in communities.
Grafova et al. identified at least two traits of the built environment that were significantly associated with overweight and obesity: neighborhood organization and number of food shops. A high level of street connectivity, with neighborhoods organized in grids versus loops, was protective against overweight and obesity in women. This supports the previously identified association between neighborhood layout, accessibility to physical activity, and obesity.5,6 The authors then created a density factor, which included the number of food stores, restaurants, housing units per square mile, and population density. Density was found to be mildly protective against overweight and obesity in both men and women, consistent with previous investigations that the number of food stores improves health outcomes by increased availability of affordable fruits and vegetables.7
Underserved communities have the highest need for built environment interventions because they are characterized by limited financial resources4 and poor infrastructure.8 As an illustration that these types of interventions can be effective, Economos et al.'s study in a culturally diverse urban setting where they implemented farmer's market initiatives and city ordinances promoting walkability reported reduced pediatric weight gain in the intervention group compared with control.3 Grafova et al.'s work1 and the work of others9,10 identify neighborhood traits upon which to build innovative built environment interventions and municipal and regional policies on mixed land use. This multidisciplinary approach can reduce obesity rates by creating healthy living environments that promote the transition from healthful intention to healthful behavior.
Author: Anne L. Escaron
Institution: University of Wisconsin–Madison
Language: English
Subfield: Transportation
Field: Social Sciences
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W1983279573