Boehmer T K, Hoehner C M, Deshpande A D, Brennan Ramirez L K, Brownson R C
Prevention Research Center and Department of Community Health, School of Public Health, Saint Louis University, St Louis, MO, USA.
Int J Obes (Lond). 2007 Jun;31(6):968-77. doi: 10.1038/sj.ijo.0803531. Epub 2007 Jan 16.
The global obesity epidemic has been partially attributed to modern environments that encourage inactivity and overeating, yet few studies have examined specific features of the physical neighborhood environment that influence obesity. Using two different measurement methods, this study sought to identify and compare perceived and observed neighborhood indicators of obesity and a high-risk profile of being obese and inactive.
Cross-sectional telephone surveys (perceived) and street-scale environmental audits (observed) were conducted concurrently in two diverse US cities to assess recreational facility access, land use, transportation infrastructure and aesthetics.
A total of 1032 randomly selected urban residents (20% obese, 32% black, 65% female).
Bivariate and multivariate logistic regression analyses were conducted to estimate the association (adjusted prevalence odds ratio (aOR)) between the primary outcome (obese vs normal weight) and perceived and observed environmental indicators, controlling for demographic variables.
Being obese was significantly associated with perceived indicators of no nearby nonresidential destinations (aOR=2.2), absence of sidewalks (aOR=2.2), unpleasant community (aOR=3.1) and lack of interesting sites (aOR=4.8) and observed indicators of poor sidewalk quality (aOR=2.1), physical disorder (aOR=4.0) and presence of garbage (aOR=3.7). Perceived and observed indicators of land use and aesthetics were the most robust neighborhood correlates of obesity in multivariate analyses.
The findings contribute substantially to the growing evidence base of community-level correlates of obesity and suggest salient environmental and policy intervention strategies that may reduce population-level obesity prevalence. Continued use of both measurement methods is recommended to clarify inconsistent associations across perceived and observed indicators within the same domain.
全球肥胖流行部分归因于鼓励久坐不动和暴饮暴食的现代环境，但很少有研究考察影响肥胖的邻里物理环境的具体特征。本研究使用两种不同的测量方法，旨在识别和比较感知到的和观察到的邻里肥胖指标以及肥胖和缺乏运动的高风险特征。
在美国两个不同城市同时进行横断面电话调查（感知）和街道尺度环境审计（观察），以评估娱乐设施可达性、土地利用、交通基础设施和美观程度。
共随机选取1032名城市居民（20%肥胖，32%为黑人，65%为女性）。
进行双变量和多变量逻辑回归分析，以估计主要结局（肥胖与正常体重）与感知和观察到的环境指标之间的关联（调整患病率比值比（aOR）），并控制人口统计学变量。
肥胖与感知到的附近无非居住目的地指标（aOR=2.2）、没有人行道（aOR=2.2）、社区氛围不佳（aOR=3.1）和缺乏有趣场所（aOR=4.8）以及观察到的人行道质量差（aOR=2.1）、环境杂乱（aOR=4.0）和有垃圾（aOR=3.7）显著相关。在多变量分析中，感知和观察到的土地利用和美观指标是与肥胖最密切相关的邻里因素。
这些发现为肥胖的社区层面相关因素的证据基础不断增加做出了重要贡献，并提出了可能降低人群肥胖患病率的显著环境和政策干预策略。建议继续使用这两种测量方法，以澄清同一领域内感知和观察到的指标之间不一致的关联。
