Background
Financially disadvantaged populations are more likely to live in communities that
do not support healthy choices. This paper investigates whether certain characteristics
of the built environment are associated with obesity or coronary heart disease (CHD)
risk among uninsured low-income women.
Methods
Using a sample of 2001–2002 data from 2692 women enrolled in the WISEWOMAN program
of the Centers for Disease Control and Prevention, the study team performed regression
analysis (conducted in January–April 2005) to estimate body mass index (BMI) and the
log of 10-year CHD risk as a function of the built environment and socioecologic measures.
Results
For women living in an environment of maximum mixed land use (i.e., an environment
more conducive to healthy living), BMI was lower by 2.60 kg/m2 and CHD risk was lower by 20% than for women living in single-use uniform environments
(i.e., environments less conducive to healthy living). An additional fitness facility
per 1000 residents was associated with BMI and CHD risk that were lower by 1.39 kg/m2 and 15.1%, respectively. Crime was positively associated with BMI and CHD risk, whereas
neighborhood affluence was negatively associated. Living in more racially segregated
areas was negatively associated with CHD risk among black, Hispanic, and Asian women
and positively associated with CHD risk among American Indian women.
Conclusions
The built environment and socioecologic characteristics of financially disadvantaged
women were associated with BMI and CHD risk. More research is needed to understand
the effects of racial segregation or acculturation on health for specific subpopulations.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to American Journal of Preventive MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Women and heart disease. Office for Social Environment and Health Research, West Virginia University, Morgantown WV1999
- Cardiovascular disease in women.Circulation. 1997; 96: 2468-2482
- A review of health-related quality of life and psychosocial factors in women with cardiovascular disease.Ann Behav Med. 1993; 15: 149-155
- By neglecting deprivation, cardiovascular risk scoring will exacerbate social gradients in disease.Heart. 2005 (In press)
- Racial and spatial relations as fundamental determinants of health in Detroit.Milbank Q. 2002; 80: 677-707
- Racial residential segregation.Public Health Rep. 2001; 116: 404-416
- Toward a systematic approach to understanding—and ultimately eliminating—African American women’s health disparities.Women’s Health Issues. 2002; 12: 222-237
- Age, socioeconomic status, and health.Milbank Q. 1990; 68: 383-411
- Social conditions as fundamental causes of disease.J Health Soc Behav. 1995; : 80-94
- The influence of physical activity, socioeconomic status, and ethnicity on the weight status of adolescents.Obes Res. 2000; 8: 130-139
- The influence of socioeconomic status, ethnicity, and lifestyle on body mass index in a longitudinal study.Int J Epidemiol. 1998; 27: 57-63
- The relationship between social status and body mass index in the Minnesota Heart Health Program.Int J Obes. 1989; 13: 59-67
- An ecological study of the relationship between social and environmental determinants of obesity.Health Place. 2002; 8: 141-145
- Fast food, race/ethnicity, and income.Am J Prev Med. 2004; 27: 211-217
- The contextual effect of the local food environment on residents’ diets.Am J Public Health. 2002; 92: 1761-1777
- The relative influence of individual, social, and physical environment determinants of physical activity.Soc Sci Med. 2002; 54: 1793-1812
- Personal, social, and physical environmental correlates of physical activity in African-American women in South Carolina.Am J Prev Med. 2003; 25: 23-29
- Quantitative study of correlates of physical activity in women from diverse racial/ethnic groups.Am J Prev Med. 2003; 25: 5-36
- Environmental and policy interventions to promote physical activity.Am J Prev Med. 1998; 15: 379-397
- Sorting out the connections between the built environment and health.J Urban Health. 2003; 80: 556-568
- Walking, bicycling, and urban landscapes.J Public Health. 2003; 93: 1478-1483
- Understanding the link between urban form and non-work travel behavior.J Plan Educ Res. 1996; 15: 183-198
- Obesity relationships with community design, physical activity, and time spent in cars.Am J Prev Med. 2004; 27: 87-96
- Relationship between urban sprawl and physical activity, obesity, and morbidity.Am J Health Promot. 2003; 18: 47-57
- Neighborhood-based differences in physical activity.Am J Public Health. 2003; 93: 1552-1558
- How the built environment affects physical activity.Am J Prev Med. 2002; 23: 64-73
- Associations between self-reported and objective physical environmental factors and use of a community rail-trail.Prev Med. 2001; 32: 191-200
- Using ArcGIS to study community characteristics and physical activity in adolescent girls. Paper presented at 23rd Environmental Systems Research Institute International User Conference, San Diego CA2003
- A micro-analysis of land use and travel in five neighborhoods in the San Francisco Bay Area.Transportation. 1997; 24: 125-158
- Distance between homes and exercise facilities related to frequency of exercise among San Diego residents.Public Health Rep. 1990; 105: 179-185
- Active transportation and physical activity.Transportation Res Policy Pract. 2004; 38: 249-268
- Environmental correlates of walking and cycling.Ann Behav Med. 2003; 25: 80-91
- Perceived personal, social and environmental barriers to weight maintenance among young women.Int J Behav Nutr Phys Act. 2004; 1: 15-36
- Social ecological correlates of physical activity in normal weight, overweight, and obese individuals.Int J Obes (Lond). 2005; 29: 720-726
- Involving support partners in obesity treatment.J Consult Clin Psychol. 2005; 73: 341-343
- Role of social support in lifestyle-focused weight management interventions.Eur J Clin Nutr. 2005; 59: S179-S186
- Neighborhood environments and coronary heart disease.Am J Epidemiol. 1997; 146: 48-63
- A multilevel analysis of income inequality and cardiovascular disease risk factors.Soc Sci Med. 2000; 50: 673-687
- An updated coronary risk profile.Circulation. 1991; 83: 356-362
- The behavior of maximum likelihood estimates under nonstandard conditions.in: Proceedings of the 5th Berkeley Symposium on Mathematical Statistics and Probability. Vol. 1. University of California Press, Berkeley1967: 221-223
- A heteroskedasticity-consistent covariance matrix estimator and a direct test for heteroskedasticity.Econometrica. 1980; 48: 817-830
- Consistent covariance matrix estimation with cross-sectional dependence and heteroskedasticity in financial data.J Financial Quant Anal. 1989; 24: 333-355
- The dimensions of residential segregation.Soc Forces. 1988; 67: 281-315
- Higher fat intake and lower fruit and vegetables intakes are associated with greater acculturation among Mexicans living in Washington State.J Am Diet Assoc. 2004; 104: 51-57
- Intake and food sources of macronutrients among Hispanic elders.J Am Diet Assoc. 2000; 100: 665-673
- The association between length of residence and obesity among Hispanic immigrants.Am J Prev Med. 2004; 27: 323-326
- The longer you stay, the bigger you get.Am J Phys Anthropol. 2004; 125: 90-96
- Impacts of mixed use and density on utilization of three modes of travel.Transportation Res Record. 1995; 1466: 44-52
Article info
Footnotes
RTI International is a trade name of Research Triangle Institute.
Identification
Copyright
© 2006 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
