Relationship between perceptions about neighborhood environment and prevalent obesity: data from the dallas heart study

Authors

  • Tiffany M. Powell-Wiley,

    Corresponding author
    1. Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
    2. Applied Research Program, Division of Cancer Control and Population Studies, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
    • Cardiovascular and Pulmonary Branch, National Heart, Lung, and Blood Institute
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  • Colby R. Ayers,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • James A. de Lemos,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
    2. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • Susan G. Lakoski,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
    2. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • Gloria L. Vega,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • Scott Grundy,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • Sandeep R. Das,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
    2. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • Kamakki Banks-Richard,

    1. Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center, Dallas, Texas, USA
    2. Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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  • Michelle A. Albert

    1. Donald W. Reynolds Center for Cardiovascular Research, Divisions of Cardiovascular and Preventive Medicine, Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
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  • Disclosure: The authors declared no conflicts of interest.

  • Funding agencies: Funding support for Dr. Powell-Wiley and Dr. Banks-Richard was provided by the Ruth Kirschstein National Research Service Award from the National Institutes of Health (#2-T32-HL007360-31). Dr. Powell-Wiley is currently funded by the Division of Intramural Research of the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health. Dr. Albert is funded by the National Institute of Health (RO1 AG038492). Funding support for the Dallas Heart Study was provided by the Donald W. Reynolds Foundation (Las Vegas, NV) and the United States Public Health Service General Clinical Research Center grant #MO1-RR00633 from the National Institutes of Health/National Center Research Resources-Clinical Research.

Abstract

Objectives:

Although psychosocial stress can result in adverse health outcomes, little is known about how perceptions of neighborhood conditions, a measure of environment-derived stress, may impact obesity. The association between perceptions of neighborhood environment and obesity (defined as body mass index [BMI] ≥ 30 kg/m2) among 5,907 participants in the Dallas Heart Study, a multi-ethnic, probability-based sample of Dallas County residents was examined.

Design and Methods:

Participants were asked to respond to 18 questions about perceptions of their neighborhood. Factor analysis was used to identify three factors associated with neighborhood perceptions: neighborhood violence, physical environment, and social cohesion. Logistic regression analyses were performed to determine the relationship between each factor (higher quintile = more unfavorable perceptions) and the odds of obesity.

Results:

Decreasing age, income, and education associated with unfavorable overall neighborhood perceptions and unfavorable perceptions about specific neighborhood factors (P trend <0.05 for all). Increasing BMI was associated with unfavorable perceptions about physical environment (P trend <0.05) but not violence or social cohesion. After adjustment for race, age, sex, income, education, and length of residence, physical environment perception score in the highest quintile remained associated with a 25% greater odds of obesity (OR 1.25, [95% CI 1.03-1.50]). Predictors of obesity related to environmental perceptions included heavy traffic (OR 1.39, [1.17-1.64]), trash/litter in neighborhood (OR 1.27, [1.01-1.46]), lack of recreational areas (OR 1.21, [1.01-1.46]), and lack of sidewalks (OR 1.25, [95% CI 1.04-1.51]).

Conclusions:

Thus, unfavorable perceptions of environmental physical conditions are related to increased obesity. Efforts to improve the physical characteristics of neighborhoods, or the perceptions of those characteristics, may assist in the prevention of obesity in this community.

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