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Obesity and Supermarket Access: Proximity or Price?

Drewnowski, Adam; Aggarwal, Anju; Hurvitz, Philip M.; Monsivais, Pablo; Moudon, Anne V. (2012). Obesity and Supermarket Access: Proximity or Price? American Journal Of Public Health, 102(8), e74 – e80.

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Abstract

Objectives. We examined whether physical proximity to supermarkets or supermarket price was more strongly associated with obesity risk. Methods. The Seattle Obesity Study (SOS) collected and geocoded data on home addresses and food shopping destinations for a representative sample of adult residents of King County, Washington. Supermarkets were stratified into 3 price levels based on average cost of the market basket. Sociodemographic and health data were obtained from a telephone survey. Modified Poisson regression was used to test the associations between obesity and supermarket variables. Results. Only 1 in 7 respondents reported shopping at the nearest supermarket. The risk of obesity was not associated with street network distances between home and the nearest supermarket or the supermarket that SOS participants reported as their primary food source. The type of supermarket, by price, was found to be inversely and significantly associated with obesity rates, even after adjusting for individual-level sociodemographic and lifestyle variables, and proximity measures (adjusted relative risk = 0.34; 95% confidence interval = 0.19, 0.63) Conclusions. Improving physical access to supermarkets may be one strategy to deal with the obesity epidemic; improving economic access to healthy foods is another. [ABSTRACT FROM AUTHOR]; Copyright of American Journal of Public Health is the property of American Public Health Association and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Keywords

Natural Foods; Obesity Risk Factors; Surveys; Cluster Analysis (statistics); Confidence Intervals; Correlation (statistics); Food Service; Geographic Information Systems; Poisson Distribution; Population Geography; Research Funding; User Charges; Residential Patterns; Socioeconomic Factors; Relative Medical Risk; Statistical Models; Descriptive Statistics; Economics; Washington (state)

Environments Perceived as Obesogenic Have Lower Residential Property Values

Drewnowski, Adam; Aggarwal, Anju; Rehm, Colin D.; Cohen-Cline, Hannah; Hurvitz, Philip M.; Moudon, Anne V. (2014). Environments Perceived as Obesogenic Have Lower Residential Property Values. American Journal Of Preventive Medicine, 47(3), 260 – 274.

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Abstract

Background: Studies have tried to link obesity rates and physical activity with multiple aspects of the built environment. Purpose: To determine the relation between residential property values and multiple perceived (self-reported) measures of the obesogenic environment. Methods: The Seattle Obesity Study (SOS) used a telephone survey of a representative, geographically distributed sample Of 2,001 King County adults, collected in 2008-2009 and analyzed in 2012-2013. Home addresses were geocoded. Residential property values at the tax parcel level were obtained from the King County tax assessor. Mean residential property values within a 10-minute walk (833-m buffer) were calculated for each respondent. Data on multiple perceived measures of the obesogenic environment were collected by self-report. Correlations and multi-variable linear regression analyses, stratified by residential density, were used to examine the associations among perceived environmental measures, property values, and BMI. Results: Perceived measures of the environment such as crime, heavy traffic, and proximity to bars, liquor stores, and fast food were all associated with lower property values. By contrast, living in neighborhoods that were perceived as safe, quiet, clean, and attractive was associated with higher property values. Higher property values were associated, in turn, with lower BMIs among women. The observed associations between perceived environment measures and BMI were largely attenuated after accounting for residential property values. Conclusions: Environments perceived as obesogenic are associated with lower property values. Studies in additional locations need to explore to what extent other perceived environment measures can be reflected in residential property values. (C) 2014 American Journal of Preventive Medicine

Keywords

Body-mass Index; Physical-activity; Objective Measures; Childhood Obesity; Food Stores; Neighborhood Disorder; Atherosclerosis Risk; Collective Efficacy; Racial Composition; Built Environment

Health Implications of Adults’ Eating at and Living Near Fast Food or Quick Service Restaurants

Jiao, J.; Moudon, A. V.; Kim, S. Y.; Hurvitz, P. M.; Drewnowski, A. (2015). Health Implications of Adults’ Eating at and Living Near Fast Food or Quick Service Restaurants. Nutrition & Diabetes, 5.

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Abstract

BACKGROUND: This paper examined whether the reported health impacts of frequent eating at a fast food or quick service restaurant on health were related to having such a restaurant near home. METHODS: Logistic regressions estimated associations between frequent fast food or quick service restaurant use and health status, being overweight or obese, having a cardiovascular disease or diabetes, as binary health outcomes. In all, 2001 participants in the 2008-2009 Seattle Obesity Study survey were included in the analyses. RESULTS: Results showed eating >= 2 times a week at a fast food or quick service restaurant was associated with perceived poor health status, overweight and obese. However, living close to such restaurants was not related to negative health outcomes. CONCLUSIONS: Frequent eating at a fast food or quick service restaurant was associated with perceived poor health status and higher body mass index, but living close to such facilities was not.

Keywords

Body-mass Index; Socioeconomic-status; Built Environment; Obesity; Association; Consumption; Weight; Proximity; Outlets; Establishments

Perceptions And Expected Immediate Reactions To Tornado Warning Polygons

Lindell, Michael K.; Huang, Shih-kai; Wei, Hung-lung; Samuelson, Charles D. (2016). Perceptions And Expected Immediate Reactions To Tornado Warning Polygons. Natural Hazards, 80(1), 683 – 707.

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Abstract

To provide people with more specific information about tornado threats, the National Weather Service has replaced its county-wide warnings with smaller warning polygons that more specifically indicate the risk area. However, tornado warning polygons do not have a standardized definition regarding tornado strike probabilities (p (s)) so it is unclear how warning recipients interpret them. To better understand this issue, 155 participants responded to 15 hypothetical warning polygons. After viewing each polygon, they rated the likelihood of a tornado striking their location and the likelihood that they would take nine different response actions ranging from continuing normal activities to getting in a car and driving somewhere safer. The results showed participants inferred that the p (s) was highest at the polygon's centroid, lower just inside the edges of the polygon, still lower (but not zero) just outside the edges of the polygon, and lowest in locations beyond that. Moreover, higher p (s) values were associated with lower expectations of continuing normal activities and higher expectations of seeking information from social sources (but not environmental cues) and higher expectations of seeking shelter (but not evacuating in their cars). These results indicate that most people make some errors in their p (s) judgments but are likely to respond appropriately to the p (s) they infer from the warning polygons. Overall, the findings from this study and other research can help meteorologists to better understand how people interpret the uncertainty associated with warning polygons and, thus, improve tornado warning systems.

Keywords

Interrater Agreement; Protective Action; Decision-making; Evacuation; Risk; Uncertainty; Residents; Disaster; Probabilities; Preparedness; Tornado Warning Polygons; Risk Perceptions; Protective Actions

GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity

James, Peter; Hart, Jaime E.; Hipp, J. Aaron; Mitchell, Jonathan A.; Kerr, Jacqueline; Hurvitz, Philip M.; Glanz, Karen; Laden, Francine. (2017). GPS-Based Exposure to Greenness and Walkability and Accelerometry-Based Physical Activity. Cancer Epidemiology Biomarkers & Prevention, 26(4), 525 – 532.

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Abstract

Background: Physical inactivity is a risk factor for cancer that may be influenced by environmental factors. Indeed, dense and well-connected built environments and environments with natural vegetation may create opportunities for higher routine physical activity. However, studies have focused primarily on residential environments to define exposure and self-reported methods to estimate physical activity. This study explores the momentary association between minute-level global positioning systems (GPS)-based greenness exposure and time-matched objectively measured physical activity. Methods: Adult women were recruited from sites across the United States. Participants wore a GPS device and accelerometer on the hip for 7 days to assess location and physical activity at minutelevel epochs. GPS records were linked to 250mresolution satellitebased vegetation data and Census Block Group-level U.S. Environmental Protection Agency (EPA) Smart Location Database walkability data. Minute-level generalized additive mixed models were conducted to test for associations between GPS measures and accelerometer count data, accounting for repeated measures within participant and allowing for deviations fromlinearity using splines. Results: Among 360 adult women (mean age of 55.3 +/- 10.2 years), we observed positive nonlinear relationships between physical activity and both greenness and walkability. In exploratory analyses, the relationships between environmental factors and physical activity were strongest among those who were white, had higher incomes, and who were middle-aged. Conclusions: Our results indicate that higher levels of physical activity occurred in areas with higher greenness and higher walkability. Impact: Findings suggest that planning and design policies should focus on these environments to optimize opportunities for physical activity. (C) 2017 AACR.

Keywords

Built Environments; Health Research; Breast-cancer; Obesity; Neighborhood; Validation; Validity; Walking; Risk; Energetics

Physical and Mental Health Impacts of Household Gardens in an Urban Slum in Lima, Peru

Korn, Abigail; Bolton, Susan M.; Spencer, Benjamin; Alarcon, Jorge A.; Andrews, Leann; Voss, Joachim G. (2018). Physical and Mental Health Impacts of Household Gardens in an Urban Slum in Lima, Peru. International Journal Of Environmental Research And Public Health, 15(8).

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Abstract

Rural poverty and lack of access to education has led to urban migration and fed the constant growth of urban slums in Lima, Peru. Inhabitants of these informal settlements lack land rights and access to a public water supply, resulting in poor sanitation, an inability to grow food, and suboptimal health outcomes. A repeated measures longitudinal pilot study utilizing participatory design methods was conducted in Lima between September 2013 and September 2014 to determine the feasibility of implementing household gardens and the subsequent impact of increased green space on well-being. Anthropometric data and a composite of five validated mental health surveys were collected at the baseline, 6-months, and 12-months after garden construction. Significant increases from the baseline in all domains of quality of life, including: physical (p < 0.01), psychological (p = 0.05), social (p = 0.02), environmental (p = 0.02), and overall social capital (p < 0.01) were identified 12 months after garden construction. Life-threatening experiences decreased significantly compared to the baseline (p = 0.02). There were no significant changes in parent or partner empathy (p = 0.21), BMI (p = 0.95), waist circumference (p = 0.18), or blood pressure (p = 0.66) at 6 or 12 months. Improved access to green space in the form of a household garden can significantly improve mental health in an urban slum setting.

Keywords

Of-life Assessment; Psychometric Properties; Threatening Experiences; Vegetable Consumption; Developing-countries; Community Garden; Climate-change; Green Space; Poverty; Participation; Mental Health; Peru; Quality Of Life; Urban Slum; Social Capital

Cohort Profile: Twins Study of Environment, Lifestyle Behaviours and Health

Duncan, Glen E.; Avery, Ally; Hurvitz, Philip M.; Moudon, Anne Vernez; Tsang, Siny; Turkheimer, Eric. (2019). Cohort Profile: Twins Study of Environment, Lifestyle Behaviours and Health. International Journal Of Epidemiology, 48(4), 1041.

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Keywords

Twin Studies; Neighborhoods; Native Americans; Normalized Difference Vegetation Index; Life Style; Twins; Body-mass Index; Physical-activity; Neighborhood Walkability; Waist Circumference; Built Environment; Causal Inference; Deprivation; Validation; Registry; Obesity

A Cross-Sectional Analysis of Physical Activity and Weight Misreporting in Diverse Populations: The Seattle Obesity Study III

Buszkiewicz, James; Rose, Chelsea; Gupta, Shilpi; Ko, Linda K.; Mou, Jin; Moudon, Anne, V; Hurvitz, Philip M.; Cook, Andrea; Aggarwal, Anju; Drewnowski, Adam. (2020). A Cross-Sectional Analysis of Physical Activity and Weight Misreporting in Diverse Populations: The Seattle Obesity Study III. Obesity Science & Practice, 6(6), 615 – 627.

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Abstract

Background: In-person assessments of physical activity (PA) and body weight can be burdensome for participants and cost prohibitive for researchers. This study examined self-reported PA and weight accuracy and identified patterns of misreporting in a diverse sample. Methods: King, Pierce and Yakima county residents, aged 21-59 years (n= 728), self-reported their moderate-to-vigorous PA (MVPA) and weight, in kilograms. Self-reports were compared with minutes of bout-level MVPA, from 3 days of accelerometer data, and measured weights. Regression models examined characteristics associated with underreporting and overreporting of MVPA and weight, the potential bias introduced using each measure and the relation between perceived and measured PA and weight. Results: MVPA underreporting was higher among males and college educated participants; however, there was no differential MVPA overreporting. Weight underreporting was higher among males, those age 40-49 years and persons with obesity. Weight overreporting was higher among Hispanic participants and those reporting stress, unhappiness and fair or poor health. The estimated PA-obesity relation was similar using measured and self-reported PA but not self-reported weight. Perceived PA and weight predicted measured values. Conclusion: Self-reported PA and weight may be useful should objective measurement be infeasible; however, though population-specific adjustment for differential reporting should be considered.

Keywords

Self-reported Weight; Sedentary Behavior; Validation; Accuracy; Height; Adults; Health Disparity; Obesity; Physical Activity; Self-reported Outcomes

Motorcycle Taxi Programme Increases Safe Riding Behaviours Among Its Drivers In Kampala, Uganda

Muni, Kennedy; Kobusingye, Olive; Mock, Charles; Hughes, James P.; Hurvitz, Philip M.; Guthrie, Brandon. (2020). Motorcycle Taxi Programme Increases Safe Riding Behaviours Among Its Drivers In Kampala, Uganda. Injury Prevention, 26(1), 5 – 11.

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Abstract

Background SafeBoda is a motorcycle taxi company that provides road safety training and helmets to its drivers in Kampala, Uganda. We sought to determine whether SafeBoda drivers are more likely to engage in safe riding behaviours than regular drivers (motorcycle taxi drivers not part of SafeBoda). Methods We measured riding behaviours in SafeBoda and regular drivers through: (1) computer-assisted personal interview (CAPI), where 400 drivers were asked about their riding behaviours (eg, helmet and mobile phone use) and (2) roadside observation, where riding behaviours were observed in 3000 boda-boda drivers and their passengers along major roads in Kampala. Results Across the two cross-sectional studies, a higher proportion of SafeBoda drivers than regular drivers engaged in safe riding behaviours. For instance, helmet use among SafeBoda compared with regular drivers was 21% points higher (95% CI 0.15 to 0.27; p<0.001) based on the CAPI and 45% points higher (95% CI 0.43 to 0.47; p<0.001) based on roadside observation. Furthermore, compared with regular drivers, SafeBoda drivers were more likely to report having a driver's license (66.3% vs 33.5 %; p<0.001) and a reflective jacket (99.5% vs 50.5 %; p<0.001) and were less likely to report driving towards oncoming traffic (4% vs 45.7 %; p<0.001) in the past 30 days. Conclusion The SafeBoda programme is associated with increased safe riding behaviours among motorcycle taxi drivers in Kampala. Therefore, the promotion and expansion of such programmes may lead to a reduction in morbidity and mortality due to road injuries.

Keywords

Multiple-imputation; Helmet Use; Knowledge; Injuries; Riders

Advancing Research in Transportation and Public Health: A Selection of Twenty Project Ideas from a US Research Roadmap

Dannenberg, Andrew L.; Rodriguez, Daniel A.; Sandt, Laura S. (2021). Advancing Research in Transportation and Public Health: A Selection of Twenty Project Ideas from a US Research Roadmap. Journal Of Transport & Health, 21.

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Abstract

Background: Transportation policies and projects have multiple impacts on health. Research on these impacts can help promote positive and reduce adverse health consequences of decisions made by transportation agencies. Methods: In 2019 the U.S. National Cooperative Highway Research Program published a research roadmap for transportation and public health based on an extensive literature search and key informant interviews. The roadmap identified 44 research gaps and 122 research needs on a wide range of relevant topics. From this list, using pre-established criteria including specificity, equity, potential impact, and long-term usefulness, we selected 20 topics suitable for further research especially in academic settings. Results: We present the questions, context, and possible research approach for each of the 20 topics. These topics cover issues ranging from integrating equity into performance measures and developing forecasting models for active travel to incorporating health questions into routine household travel surveys and examining health impacts of autonomous vehicles. We added questions on the impacts of the COVID-19 pandemic on transportation. Discussion: This list will be useful to faculty, researchers, and students as they consider topics for research in transportation and public health. Results of research on these topics could influence transportation decisions in policy making, planning and community participation, capital programming, project design, and implementation. Future leaders of transportation agencies, transportation providers, and advocacy organizations may be more likely to consider transportation policies that incorporate a health perspective if their training includes research findings that increase their awareness of the health impacts of these policies.

Keywords

Public Health; Equity; Research; Public Transit; Metrics; Transportation Planning