School of Geography and Earth Sciences, McMaster University, Hamilton, ON, Canada.
Health Place. 2010 Mar;16(2):389-98. doi: 10.1016/j.healthplace.2009.11.011. Epub 2009 Dec 2.
Overweight/obesity represent a significant public health problem in Canada and abroad. The objective of this paper is to identify potential associations between overweight/obesity and individual as well as socio-environmental determinants. The data sources used are the 2003 Canadian Community Health Survey and the Desktop Mapping Technologies Incorporated database. Geographical Information Systems are first employed to create neighbourhood-level variables such as neighbourhood walkability and fast food accessibility. Multivariate analysis is then applied to estimate the relative effects of individual- and neighbourhood-level risk-factors of overweight/obesity. Results demonstrate the important role of the built-environment after adjustment for demographic, socio-economic and behavioural characteristics. Findings support the rationale that reversing current trends will require a multifaceted public health approach where interventions are developed from the individual- to the neighbourhood-level, with a particular focus on altering obesogenic environments.
超重/肥胖是加拿大乃至全球的一个重大公共卫生问题。本文旨在确定超重/肥胖与个体及社会环境决定因素之间的潜在关联。本文使用的数据来源是 2003 年加拿大社区健康调查和桌面地图技术公司数据库。首先,地理信息系统被用于创建社区层面的变量,如社区的步行性和快餐可达性。然后,采用多变量分析来估计超重/肥胖个体和社区层面风险因素的相对影响。研究结果表明,在调整了人口统计学、社会经济和行为特征后,建筑环境发挥了重要作用。这些发现支持了这样一种观点,即扭转当前的趋势需要采取一种多方面的公共卫生方法,从个体层面到社区层面进行干预,特别关注改变肥胖环境。