Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
Obesity (Silver Spring). 2013 Jan;21(1):E14-21. doi: 10.1002/oby.20012.
Although psychosocial stress can result in adverse health outcomes, little is known about how perceptions of neighborhood conditions, a measure of environment-derived stress, may impact obesity. The association between perceptions of neighborhood environment and obesity (defined as body mass index [BMI] ≥ 30 kg/m(2) ) among 5,907 participants in the Dallas Heart Study, a multi-ethnic, probability-based sample of Dallas County residents was examined.
Participants were asked to respond to 18 questions about perceptions of their neighborhood. Factor analysis was used to identify three factors associated with neighborhood perceptions: neighborhood violence, physical environment, and social cohesion. Logistic regression analyses were performed to determine the relationship between each factor (higher quintile = more unfavorable perceptions) and the odds of obesity.
Decreasing age, income, and education associated with unfavorable overall neighborhood perceptions and unfavorable perceptions about specific neighborhood factors (P trend <0.05 for all). Increasing BMI was associated with unfavorable perceptions about physical environment (P trend <0.05) but not violence or social cohesion. After adjustment for race, age, sex, income, education, and length of residence, physical environment perception score in the highest quintile remained associated with a 25% greater odds of obesity (OR 1.25, [95% CI 1.03-1.50]). Predictors of obesity related to environmental perceptions included heavy traffic (OR 1.39, [1.17-1.64]), trash/litter in neighborhood (OR 1.27, [1.01-1.46]), lack of recreational areas (OR 1.21, [1.01-1.46]), and lack of sidewalks (OR 1.25, [95% CI 1.04-1.51]).
Thus, unfavorable perceptions of environmental physical conditions are related to increased obesity. Efforts to improve the physical characteristics of neighborhoods, or the perceptions of those characteristics, may assist in the prevention of obesity in this community.
虽然心理社会压力会导致不良健康后果，但人们对环境压力源的感知如何影响肥胖知之甚少。本研究旨在探讨达拉斯心脏研究（Dallas Heart Study）中 5907 名参与者的邻里环境感知与肥胖（BMI≥30kg/m2）之间的关系，该研究是一项基于多民族的达拉斯县居民概率样本的研究。
参与者被要求回答 18 个关于其邻里环境感知的问题。采用因子分析来确定与邻里感知相关的三个因素：邻里暴力、物理环境和社会凝聚力。采用 logistic 回归分析来确定每个因素（五分位数越高=感知越不利）与肥胖几率之间的关系。
年龄、收入和教育水平的降低与不利的整体邻里感知以及对特定邻里因素的不利感知相关（P 趋势<0.05）。BMI 的增加与物理环境感知不良相关（P 趋势<0.05），但与暴力或社会凝聚力无关。在校正种族、年龄、性别、收入、教育程度和居住时间后，处于最高五分位数的物理环境感知评分仍与肥胖几率增加 25%相关（OR 1.25，95%CI 1.03-1.50）。与环境感知相关的肥胖预测因素包括交通拥堵（OR 1.39，95%CI 1.17-1.64）、邻里垃圾/杂物（OR 1.27，95%CI 1.01-1.46）、缺乏娱乐区（OR 1.21，95%CI 1.01-1.46）和缺乏人行道（OR 1.25，95%CI 1.04-1.51）。
因此，对环境物理条件的不利感知与肥胖的增加有关。改善邻里环境物理特征或这些特征的感知，可能有助于预防该社区的肥胖。
