Features of the built environment related to physical activity friendliness and children's obesity and other risk factors.

OBJECTIVES

We investigated the relationships among environmental features of physical activity friendliness, socioeconomic indicators, and prevalence of obesity (BMI status), central adiposity (waist circumference, waist-height ratio), and hypertension.

DESIGN AND SAMPLE

The design was cross-sectional; the study was correlational. The sample was 911 kindergarteners through sixth graders from three schools in an urban school district residing in 13 designated neighborhoods.

MEASURES

Data from walking environmental community audits, census data for socioeconomic indicators, body mass index, waist circumference, waist-height ratio, and blood pressure were analyzed. A modified Alfonzo's Hierarchy of Walking Needs model was the conceptual framework for environmental features (i.e., accessibility, safety, comfort, and pleasurability) related to physical activity.

RESULTS

Accessibility was significantly and negatively correlated with prevalence of obesity and with prevalence of a waist-height ratio >0.50. When neighborhood education was controlled, and when both neighborhood education and poverty were controlled with partial correlational analysis, comfort features of a walking environment were significantly and positively related to prevalence of obesity. When poverty was controlled with partial correlation, accessibility was significantly and negatively correlated with prevalence of waist-height ratio >0.50.

CONCLUSIONS

The built environment merits further research to promote physical activity and stem the obesity epidemic in children. Our approach can be a useful framework for future research.