Towne Samuel D, Lopez Michael L, Li Yajuan, Smith Matthew Lee, Warren Judith L, Evans Alexandra E, Ory Marcia G
Texas A&M School of Public Health, 1266 TAMU, College Station, TX, 77843-1266, USA.
Texas A&M AgriLife Extension, Texas A&M University, College Station, TX, 77843, USA.
J Immigr Minor Health. 2018 Aug;20(4):854-864. doi: 10.1007/s10903-017-0625-1.
Obesity is a major public health issue affecting rising medical costs and contributing to morbidity and premature mortality. We aimed to identify factors that may play a role in obesity and physical activity at the individual and environmental/neighborhood levels. We analyzed data from an adult sample who were parents of students enrolled in a school-based health and wellness program. The sample was restricted to those who were Hispanic and whose children were on free/reduced lunch (n = 377). Dependent variables: body mass index (BMI); neighborhood walkability. Walk Score was used to assess neighborhood walkability. Overall, 46% of participants were obese and 31% were overweight. The median age of respondents was 34 years, and the majority were female (88%) and married (59%). Participants who resided in a census tract with a higher relative income inequality (high, OR 2.54, 90% CI 1.154-5.601; moderate-high OR 2.527, 90% CI 1.324-4.821) and those who were unmarried (OR 1.807, 90% CI 1.119-2.917) were more likely to be obese versus normal weight. Overweight individuals that resided in areas that were walkable versus car-dependent averaged more days engaging in walking for at least 30-min (p <.05). Identifying individual and neighborhood factors associated with obesity can inform more targeted approaches to combat obesity at multiple ecological levels. The importance of understanding how neighborhood characteristics influence health-related and behavioral outcomes is further reinforced with the current findings. Identifying effective strategies to engage communities and organizations in creating, implementing, adopting, evaluating, and sustaining policy and/or environmental interventions will be needed to combat the obesity epidemic.
肥胖是一个重大的公共卫生问题,它影响着不断攀升的医疗成本,并导致发病率和过早死亡。我们旨在确定在个体层面以及环境/社区层面可能对肥胖和身体活动产生影响的因素。我们分析了一个成年样本的数据,这些成年人是参与一项校内健康与保健项目的学生的家长。样本仅限于西班牙裔且其子女享受免费/减价午餐的人群(n = 377)。因变量:体重指数(BMI);社区步行便利性。步行评分用于评估社区步行便利性。总体而言,46%的参与者肥胖,31%超重。受访者的年龄中位数为34岁,大多数为女性(88%)且已婚(59%)。居住在相对收入不平等程度较高的普查区的参与者(高不平等程度,比值比2.54,90%置信区间1.154 - 5.601;中等偏高不平等程度,比值比2.527,90%置信区间1.324 - 4.821)以及未婚参与者(比值比1.807,90%置信区间1.119 - 2.917)与体重正常者相比,更有可能肥胖。居住在适宜步行而非依赖汽车出行地区的超重个体平均每周至少进行30分钟步行的天数更多(p < 0.05)。确定与肥胖相关的个体和社区因素可为在多个生态层面抗击肥胖提供更具针对性的方法。当前的研究结果进一步强化了理解社区特征如何影响健康相关和行为结果的重要性。为抗击肥胖流行,需要确定有效的策略来促使社区和组织创建、实施、采用、评估并维持政策和/或环境干预措施。