Poortinga Wouter
Cardiff University, Welsh School of Architecture, King Edward VII Avenue, Cardiff, Wales CF10 3NB, UK.
Soc Sci Med. 2006 Dec;63(11):2835-46. doi: 10.1016/j.socscimed.2006.07.018. Epub 2006 Sep 6.
Obesity rates are rising rapidly across the developed and developing world. Until recently obesity research has mainly focused on biological, psychological and behavioural factors. But there is growing agreement that environmental factors play an important role as well. In this study data from the 2003 Health Survey for England (n = 14,836) were analysed from a multilevel perspective to examine (1) the associations of the perceptions of the local environment with obesity, self-rated health, and physical activity, and (2) whether physical activity mediates the association between the perceptions of the environment, and obesity and self-rated health. This study found that perceptions of the friendliness of the local environment were mainly associated with self-rated health; perceived access to leisure facilities with sports activities; perceived access to a post office with walking; and the presence of social nuisances with obesity and poor self-rated health. In addition, positive perceptions of the social environment (i.e., social support and social capital) were associated with higher levels of physical activity, and lower levels of poor self-rated health and obesity. Only limited support was found for the idea that health behaviours mediate the associations between the perceptions of the environment, obesity, and self-rated health. Controlling for the three physical activity measures only rendered a small number of associations with self-rated health non-significant, and did not affect the associations with obesity. Overall, the results show that certain aspects of the environment may contribute to the risk of obesity and poor health. More research is needed to examine the specific mechanisms that link (the perceptions of) the environment to obesity and health.
在发达国家和发展中国家，肥胖率都在迅速上升。直到最近，肥胖研究主要集中在生物、心理和行为因素上。但人们越来越一致地认为，环境因素也起着重要作用。在这项研究中，从多层次角度分析了2003年英格兰健康调查的数据（n = 14,836），以检验：（1）对当地环境的认知与肥胖、自评健康和身体活动之间的关联；（2）身体活动是否在环境认知与肥胖及自评健康之间的关联中起中介作用。本研究发现，对当地环境友好程度的认知主要与自评健康相关；对休闲设施的可及性认知与体育活动相关；对邮局的可及性认知与步行相关；社会滋扰的存在与肥胖及自评健康状况不佳相关。此外，对社会环境的积极认知（即社会支持和社会资本）与较高水平的身体活动、较低水平的自评健康不佳和肥胖相关。关于健康行为在环境认知、肥胖和自评健康之间的关联中起中介作用这一观点，仅得到了有限的支持。仅控制三项身体活动指标，只会使少数与自评健康的关联变得不显著，且不会影响与肥胖的关联。总体而言，结果表明环境的某些方面可能会增加肥胖和健康不佳的风险。需要更多研究来探究将环境（认知）与肥胖和健康联系起来的具体机制。
