Shahid Rizwan, Bertazzon Stefania
Health Services Research & Evaluation, Alberta Health Services, 2430 Southport Atrium, 10101 Southport Road SW, Calgary, AB, Canada, T2W 3N2.
Department of Geography, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada, T2N 1N4.
AIMS Public Health. 2015 Sep 8;2(4):616-637. doi: 10.3934/publichealth.2015.4.616. eCollection 2015.
Body weight is an important indicator of current and future health and it is even more critical in children, who are tomorrow's adults. This paper analyzes the relationship between childhood obesity and neighbourhood walkability in Calgary, Canada. A multivariate analytical framework recognizes that childhood obesity is also associated with many factors, including socioeconomic status, foodscapes, and environmental factors, as well as less measurable factors, such as individual preferences, that could not be included in this analysis. In contrast with more conventional global analysis, this research employs localized analysis and assesses need-based interventions. The strategy may not effectively control obesity rates, since each neighbourhood has unique characteristics that need to be addressed individually. This paper presents an innovative framework combining local analysis with simulation modeling to analyze childhood obesity. Spatial models generally do not deal with simulation over time, making it cumbersome for health planners and policy makers to effectively design and implement interventions and to quantify their impact over time. This research fills this gap by integrating geographically weighted regression (GWR), which identifies vulnerable neighbourhoods and critical factors for childhood obesity, with simulation modeling, which evaluates the impact of the suggested interventions on the targeted neighbourhoods. Neighbourhood walkability was chosen as a potential target for localized interventions, owing to the crucial role of walking in developing a healthy lifestyle, as well as because increasing walkability is relatively more feasible and less expensive then modifying other factors, such as income. Simulation results suggest that local walkability interventions can achieve measurable declines in childhood obesity rates. The results are encouraging, as improvements are likely to compound over time. The results demonstrate that the integration of GWR and simulation modeling is effective, and the proposed framework can assist in designing local interventions to control and prevent childhood obesity.
体重是当前和未来健康状况的重要指标,对于儿童而言更是至关重要,因为他们是未来的成年人。本文分析了加拿大卡尔加里市儿童肥胖与邻里步行便利性之间的关系。一个多变量分析框架认识到,儿童肥胖还与许多因素相关,包括社会经济地位、食物环境和环境因素,以及一些难以衡量的因素,如个人偏好等,而这些因素未纳入本分析。与更传统的全局分析不同,本研究采用局部分析并评估基于需求的干预措施。该策略可能无法有效控制肥胖率,因为每个社区都有其独特特征,需要分别加以应对。本文提出了一个将局部分析与模拟建模相结合的创新框架来分析儿童肥胖问题。空间模型通常不涉及随时间的模拟,这使得健康规划者和政策制定者难以有效地设计和实施干预措施并量化其长期影响。本研究通过将识别儿童肥胖易受影响社区和关键因素的地理加权回归(GWR)与评估建议干预措施对目标社区影响的模拟建模相结合,填补了这一空白。由于步行在培养健康生活方式中起着关键作用,而且提高步行便利性相对更可行且成本低于改变其他因素(如收入),因此邻里步行便利性被选为局部干预的潜在目标。模拟结果表明,局部步行便利性干预措施可使儿童肥胖率显著下降。结果令人鼓舞,因为随着时间推移改善效果可能会叠加。结果表明,地理加权回归与模拟建模的结合是有效的,所提出的框架可协助设计局部干预措施以控制和预防儿童肥胖。