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Neighborhood commuting environment and obesity in the United States: an urban-rural stratified multilevel analysis.美国邻里通勤环境与肥胖:城乡分层多水平分析
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社区通勤时间与自我报告的照料者健康行为和食物获取。

Neighborhood Commute to Work Times and Self-Reported Caregiver Health Behaviors and Food Access.

机构信息

Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics (MJ White and K Flower), University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC.

Departments of Pediatrics and Population Health (HS Yin), NYU School of Medicine, Bellevue Hospital Center, New York, NY.

出版信息

Acad Pediatr. 2019 Jan-Feb;19(1):74-79. doi: 10.1016/j.acap.2018.07.005. Epub 2018 Jul 21.

DOI:10.1016/j.acap.2018.07.005
PMID:30041009
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6321776/
Abstract

OBJECTIVE

Time spent commuting is associated with obesity. The objective of this study was to assess the relationship between neighborhood-level commute to work (CTW) times and self-reported health behaviors and food access.

METHODS

We conducted a cross-sectional analysis of caregivers with infants as part of the Greenlight Study, a multisite obesity trial in Chapel Hill, New York City, Nashville, and Miami. ZIP code-based commuting estimates were determined using the US Census American Community Survey. Self-reported health behaviors and food access data were collected by directed interview. Logistic and linear regression models were used to determine associations between neighborhood CTW times and health behaviors and food access.

RESULTS

The average neighborhood CTW time for all ZIP codes was 29 minutes (n = 846). Caregivers in longer CTW time neighborhoods were more likely to endorse fewer food choices (adjusted odds ratio [AOR], 1.39; 95% confidence interval [CI], 1.15-1.69; P = .001) and difficulty accessing markets with fresh produce (AOR, 1.51; 95% CI, 1.02-2.25; P = .04). Neighborhood CTW time >30 minutes was associated with less caregiver physical activity (AOR, 0.58; 95% CI, 0.34-0.98; P = .044). Neighborhood CTW time was inversely related to infant television time (adjusted mean, 399 minutes/day for ≤30 minutes and 256 minutes/day for >30 minutes; P = .025). New York families in longer CTW neighborhoods were more likely to report difficulty accessing markets with fresh produce (AOR, 1.80; 95% CI, 1.03-3.14; P = .039).

CONCLUSIONS

Neighborhood CTW time is associated with several self-reported health behaviors and perceived food access among caregivers with children. Neighborhood CTW times may represent city-specific features, including transportation infrastructure, which may impact the health of families.

摘要

目的

通勤时间与肥胖有关。本研究旨在评估社区通勤时间(CTW)与自我报告的健康行为和食物获取之间的关系。

方法

我们对作为 Greenlight 研究的一部分的有婴儿的照顾者进行了横断面分析,Greenlight 研究是在北卡罗来纳州教堂山、纽约市、纳什维尔和迈阿密进行的一项多地点肥胖试验。使用美国人口普查美国社区调查确定基于邮政编码的通勤估算。通过定向访谈收集自我报告的健康行为和食物获取数据。使用逻辑和线性回归模型确定社区 CTW 时间与健康行为和食物获取之间的关联。

结果

所有邮政编码的平均社区 CTW 时间为 29 分钟(n=846)。在 CTW 时间较长的社区中,照顾者更有可能表示食物选择较少(调整后的优势比 [AOR],1.39;95%置信区间 [CI],1.15-1.69;P=0.001),并且难以获得新鲜农产品的市场(AOR,1.51;95%CI,1.02-2.25;P=0.04)。社区 CTW 时间>30 分钟与照顾者体力活动减少相关(AOR,0.58;95%CI,0.34-0.98;P=0.044)。社区 CTW 时间与婴儿看电视时间呈反比(调整后的平均时间,≤30 分钟为 399 分钟/天,>30 分钟为 256 分钟/天;P=0.025)。在 CTW 时间较长的社区中,纽约家庭更有可能报告难以获得新鲜农产品的市场(AOR,1.80;95%CI,1.03-3.14;P=0.039)。

结论

社区 CTW 时间与照顾者的几种自我报告的健康行为和感知食物获取有关。社区 CTW 时间可能代表城市特定的特征,包括交通基础设施,这可能会影响家庭的健康。