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What Constitutes an Obesogenic Environment in Rural Communities?

2006; SAGE Publishing; Volume: 20; Issue: 6 Linguagem: Inglês

10.4278/0890-1171-20.6.411

2168-6602

Tegan K. Boehmer, Sarah L. Lovegreen, Debra Haire‐Joshu, Ross C. Brownson,

Noise Effects and Management

Purpose. To identify perceived indicators of the physical environment associated with obesity in rural communities. Design. Cross-sectional telephone survey. Setting. Thirteen communities in rural Missouri, Tennessee, and Arkansas, 2003. Subjects. A total of 2510 adults completed the survey and 2210 respondents were included in the analysis (74% female, 93% white, and 27% obese). Measures. The 106-item survey measured perceptions of the neighborhood environment (recreational facilities, land use, transportation/safety, aesthetics, and food environment) and health-related behaviors. The primary outcome was obese (body mass index [BMI] ≥ 30 kg/m 2 ) vs. normal weight (BMI = 18.5–24.9 kg/m 2 ). Analysis. Logistic regression was used to control for age, gender, and education. Results. Several indicators of the perceived neighborhood environment were associated with being obese (adjusted odds ratio [95% confidence interval]), including furthest distance to the nearest recreational facility (1.8 [1.3–2.4]), unpleasant community for physical activity (1.8 [1.3–2.6]), feeling unsafe from crime (2.1 [1.5–2.9]) or traffic (1.7 [1.2–2.3]), and few nonresidential destinations (1.4 [1.0–1.9]). Distance to recreational facilities and crime safety remained significant in the multivariate model, along with dietary-fat intake, sedentary behavior, and moderate/vigorous physical activity. Conclusion. This study adds to a growing evidence base of environmental correlates of obesity and makes a unique contribution regarding rural communities. If causality is established, environmental interventions that target obesogenic neighborhood features may reduce the prevalence of obesity on a population level.