Wang Siqin, Liu Yan, Lam Jack, Kwan Mei-Po
School of Earth and Environmental Sciences, University of Queensland, Room 537, Chamberlain Building, St Lucia, Queensland, 4076, Australia.
School of Earth and Environmental Sciences, University of Queensland, Room 514, Chamberlain Building, St Lucia, Queensland, 4076, Australia.
Spat Spatiotemporal Epidemiol. 2021 Nov;39:100456. doi: 10.1016/j.sste.2021.100456. Epub 2021 Aug 28.
The built environment has been identified as a key factor for health intervention and obesity prevention. However, it is still unclear to what extent the built environment is associated with obesity and general health and to what extent such an association is mediated through variation in physical activity. This study aims to examine the associations between individual characteristics, the built environment, physical activity, general health and body mass index to reveal the pathways through which the built environment is associated with the prevalence of obesity. Using data from 1,788 adults aged 18 to 65 in Queensland from Wave 16 of the Household, Income, and Labour Dynamics in Australia survey, we use geographic information system-based methods to quantify built environment factors in 5D dimensions: Density, Diversity, Design, Distance and Destination accessibility. We then employ multi-level mixed-effect models to test the hypothesised relationships between individual characteristics, the built environment, physical activity, general health and body mass index. The results indicate that physical activity is positively associated with general health and negatively associated with the prevalence of obesity. Adjusting for individual characteristics, we find that built-environment factors have direct effects on physical activity but indirect effects on general health and obesity. Among these factors, greater green space exposure plays a key role in enhancing general health and reducing obesity. Low-density and car-dependent neighbourhoods can be activity-friendly and mitigate obesity if these neighbourhoods are also equipped with easy access to green space.
建筑环境已被确定为健康干预和预防肥胖的关键因素。然而，建筑环境与肥胖及总体健康的关联程度，以及这种关联在多大程度上是通过身体活动的变化来介导的，目前仍不清楚。本研究旨在考察个体特征、建筑环境、身体活动、总体健康和体重指数之间的关联，以揭示建筑环境与肥胖患病率相关的途径。利用澳大利亚家庭、收入和劳动力动态调查第16波中来自昆士兰的1788名18至65岁成年人的数据，我们使用基于地理信息系统的方法，从密度、多样性、设计、距离和目的地可达性这五个维度对建筑环境因素进行量化。然后，我们采用多层次混合效应模型来检验个体特征、建筑环境、身体活动、总体健康和体重指数之间的假设关系。结果表明，身体活动与总体健康呈正相关，与肥胖患病率呈负相关。在调整个体特征后，我们发现建筑环境因素对身体活动有直接影响，但对总体健康和肥胖有间接影响。在这些因素中，更多地接触绿地在促进总体健康和减少肥胖方面起着关键作用。低密度且依赖汽车的社区如果也配备了方便进入的绿地，就可以对活动友好并减轻肥胖。
