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Differential Associations of the Built Environment on Weight Gain by Sex and Race/Ethnicity but Not Age

Buszkiewicz, James H.; Bobb, Jennifer F.; Kapos, Flavia; Hurvitz, Philip M.; Arterburn, David; Moudon, Anne Vernez; Cook, Andrea; Mooney, Stephen J.; Cruz, Maricela; Gupta, Shilpi; Lozano, Paula; Rosenberg, Dori E.; Theis, Mary Kay; Anau, Jane; Drewnowski, Adam. (2021). Differential Associations of the Built Environment on Weight Gain by Sex and Race/Ethnicity but Not Age. International Journal Of Obesity, 45(12), 2648 – 2656.

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Abstract

Objective To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults. Methods Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18-64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road intersection densities and counts of area supermarkets and fast food restaurants were measured with SmartMaps (800 and 5000-meter buffers) and categorized into tertiles. Linear mixed-effect models tested whether associations between BE features and weight gain at 1, 3, and 5 years differed by age, sex, and race/ethnicity, adjusting for demographics, baseline weight, and residential property values. Results Denser urban form and greater availability of supermarkets and fast food restaurants were associated with differential weight change across sex and race/ethnicity. At 5 years, the mean difference in weight change comparing the 3rd versus 1st tertile of residential density was significantly different between males (-0.49 kg, 95% CI: -0.68, -0.30) and females (-0.17 kg, 95% CI: -0.33, -0.01) (P-value for interaction = 0.011). Across race/ethnicity, the mean difference in weight change at 5 years for residential density was significantly different among non-Hispanic (NH) Whites (-0.47 kg, 95% CI: -0.61, -0.32), NH Blacks (-0.86 kg, 95% CI: -1.37, -0.36), Hispanics (0.10 kg, 95% CI: -0.46, 0.65), and NH Asians (0.44 kg, 95% CI: 0.10, 0.78) (P-value for interaction <0.001). These findings were consistent for other BE measures. Conclusion The relationship between the built environment and weight change differs across demographic groups. Careful consideration of demographic differences in associations of BE and weight trajectories is warranted for investigating etiological mechanisms and guiding intervention development.

Keywords

Body-mass Index; Socioeconomic-status; Food Environment; Obesity; Health; Outcomes; Scale; Risk; Minority & Ethnic Groups; Urban Environments; Etiology; Demographics; Sex; Residential Density; Supermarkets; Age; Race; Ethnicity; Property Values; Body Weight Gain; Electronic Medical Records; Fast Food; Electronic Health Records; Real Estate; Subgroups; Demography; Trajectory Analysis; Weight

Urban Design & Planning Interdisciplinary PhD

The Urban Design & Planning Interdisciplinary Ph.D. at the University of Washington is one of 39 Ph.D. programs in urban and regional planning in North America, and one of the oldest, founded in 1967.

This program brings together faculty from disciplines ranging from Architecture to Sociology to focus on the interdisciplinary study of urban problems and interventions. Covering scales from neighborhoods to metropolitan areas, the program addresses interrelationships between the physical environment, the built environment, and the social, economic, and political institutions and processes that shape urban areas. The breadth of this program permits students to pursue doctoral studies in the various aspects of urban design and planning as well as in a number of related social science, natural resource, and engineering areas.

The Program seeks to prepare scholars who can advance the state of research, practice, and education related to the built environment and its relationship to society and nature in metropolitan regions throughout the world. The program provides a strong interdisciplinary educational experience that draws on the resources of the entire University, and on the laboratory provided by the Seattle metropolitan region and the Pacific Northwest. The program emphasizes the educational values of interdisciplinarity, intellectual leadership and integrity, and the social values of equity, democracy and sustainability. It seeks to promote deeper understanding of the ways in which public decisions shape and are shaped by the urban physical, social, economic, and natural environment. The program envisions its graduates becoming leaders in the international community of researchers, practitioners and educators who focus on improving the quality of life and environment in metropolitan regions.

Urban Form Lab

The Urban Form Lab (UFL) research aims to affect policy and to support approaches to the design and planning of more livable environments. The UFL specializes in geospatial analyses of the built environment using multiple micro-scale data in Geographic Information Systems (GIS). Current research includes the development of novel GIS routines for performing spatial inventories and analyses of the built environment, and of spatially explicit sampling techniques. Projects address such topics as land monitoring, neighborhood and street design, active transportation, non-motorized transportation safety, physical activity, and access to food environments.

Research at the UFL has been supported by the U.S. and Washington State Departments of Transportation, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, the National Institutes of Health, and local agencies.

The Urban Form Lab is directed by Anne Vernez Moudon, Dr es Sc, a leading researcher and educator in quantifying the properties of the built environment as related to health and transportation behaviors. Philip M. Hurvitz, PhD, a veteran of geographic information science and data processing, leads data management and GIS work.

Philip Hurvitz

Phil Hurvitz is a research scientist with a primary appointment in the UW Center for Studies in Demography and Ecology, and is an Affiliate Associate Professor in Urban Design & Planning in the University of Washington College of Built Environments Urban Form Lab. He received his PhD in 2010, and has been on the faculty since 2012. He specializes in the objective measurement and analysis of the built environment using GIScience methodology. His current research investigates the relationship between health-related behaviors and built environment at fine spatial and temporal scales. Using new-generation devices that measure activity and location in real time, the data are being used to find associations between the types of activities people engage in and the types of environments people use as they go about their daily lives. He collaborates with researchers specializing in nutritional epidemiology, exercise physiology, rehabilitation medicine, and psychology for the purpose of understanding the relationships between built environment, diet, and physical activity. Phil received a Master of Forest Resources degree in 1994 at the UW College of Forest Resources where he helped develop and implement a GIS for the Makah Indian Nation. His Bachelor’s degree (1983) is from Seattle University in Humanities. Prior to his current appointment, he worked as a GIS specialist for the College of Forest Resources, the City of SeaTac, the Seattle Water Department, and an instructor at the University of Washington and Green River Community College.