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Journal ArticleDOI

Obesity relationships with community design, physical activity, and time spent in cars

TL;DR: Land-use mix had the strongest association with obesity, and relationships among urban form, walk distance, and time in a car were stronger among white than black cohorts, while relationships among the built environment, travel patterns, and weight may vary across gender and ethnicity.
About: This article is published in American Journal of Preventive Medicine.The article was published on 2004-08-01. It has received 1752 citations till now. The article focuses on the topics: Poison control.
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TL;DR: Unlike other major causes of preventable death and disability, such as tobacco use, injuries, and infectious diseases, there are no exemplar populations in which the obesity epidemic has been reversed by public health measures, which increases the urgency for evidence-creating policy action, with a priority on reduction of the supply-side drivers.

3,817 citations

Journal ArticleDOI
TL;DR: It is concluded that multilevel interventions based on ecological models and targeting individuals, social environments, physical environments, and policies must be implemented to achieve population change in physical activity.
Abstract: ▪ Abstract The thesis of this article is that multilevel interventions based on ecological models and targeting individuals, social environments, physical environments, and policies must be implemented to achieve population change in physical activity. A model is proposed that identifies potential environmental and policy influences on four domains of active living: recreation, transport, occupation, and household. Multilevel research and interventions require multiple disciplines to combine concepts and methods to create new transdisciplinary approaches. The contributions being made by a broad range of disciplines are summarized. Research to date supports a conclusion that there are multiple levels of influence on physical activity, and the active living domains are associated with different environmental variables. Continued research is needed to provide detailed findings that can inform improved designs of communities, transportation systems, and recreation facilities. Collaborations with policy resear...

2,696 citations


Cites background from "Obesity relationships with communit..."

  • ...Multidisciplinary teams are now collaborating routinely, and studies have emerged linking the walkability of neighborhoods or sprawl of regions with physical activity (25), obesity (21, 23), and risk of chronic diseases (21, 78)....

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Journal ArticleDOI
TL;DR: Results underscore a view of obesity as a social phenomenon, for which appropriate action includes targeting both economic and sociocultural factors.
Abstract: The objective of this review was to update Sobal and Stunkard’s exhaustive review of the literature on the relation between socioeconomic status (SES) and obesity (Psychol Bull 1989;105:260–75). Diverse research databases (including CINAHL, ERIC, MEDLINE, and Social Science Abstracts) were comprehensively searched during the years 1988–2004 inclusive, using ‘‘obesity,’’ ‘‘socioeconomic status,’’ and synonyms as search terms. A total of 333 published studies, representing 1,914 primarily cross-sectional associations, were included in the review. The overall pattern of results, for both men and women, was of an increasing proportion of positive associations and a decreasing proportion of negative associations as one moved from countries with high levels of socioeconomic development to countries with medium and low levels of development. Findings varied by SES indicator; for example, negative associations (lower SES associated with larger body size) for women in highly developed countries were most common with education and occupation, while positive associations for women in medium- and low-development countries were most common with income and material possessions. Patterns for women in higher- versus lower-development countries were generally less striking than those observed by Sobal and Stunkard; this finding is interpreted in light of trends related to globalization. Results underscore a view of obesity as a social phenomenon, for which appropriate action includes targeting both economic and sociocultural factors.

1,989 citations

Journal ArticleDOI
TL;DR: This committee presents one key recommendation for community action to accompany the four recommendations for individual choices to reduce cancer risk, recognizing that a supportive social environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors.
Abstract: The American Cancer Society (ACS) publishes Nutrition and Physical Activity Guidelines to serve as a foundation for its communication, policy, and community strategies and ultimately, to affect dietary and physical activity patterns among Americans. These Guidelines, published every 5 years, are developed by a national panel of experts in cancer research, prevention, epidemiology, public health, and policy, and as such, they represent the most current scientific evidence related to dietary and activity patterns and cancer risk. The ACS Guidelines include recommendations for individual choices regarding diet and physical activity patterns, but those choices occur within a community context that either facilitates or interferes with healthy behaviors. Community efforts are essential to create a social environment that promotes healthy food choices and physical activity. Therefore, this committee presents one key recommendation for community action to accompany the four recommendations for individual choices to reduce cancer risk. This recommendation for community action recognizes that a supportive social environment is indispensable if individuals at all levels of society are to have genuine opportunities to choose healthy behaviors. The ACS Guidelines are consistent with guidelines from the American Heart Association and the American Diabetes Association for the prevention of coronary heart disease and diabetes, as well as for general health promotion, as defined by the Department of Health and Human Services' 2005 Dietary Guidelines for Americans.

1,957 citations

Journal ArticleDOI
TL;DR: Assessment of the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns in US adolescents found inequality in availability ofPA facilities may contribute to ethnic and SES disparities in PA and obese patterns.
Abstract: CONTEXT. Environmental factors are suggested to play a major role in physical activity (PA) and other obesity-related behaviors, yet there is no national research on the relationship between disparity in access to recreational facilities and additional impact on PA and overweight patterns in US adolescents. OBJECTIVE. In a nationally representative cohort, we sought to assess the geographic and social distribution of PA facilities and how disparity in access might underlie population-level PA and overweight patterns. DESIGN, SETTING, AND PARTICIPANTS. Residential locations of US adolescents in wave I (1994–1995) of the National Longitudinal Study of Adolescent Health (N = 20745) were geocoded, and a 8.05-km buffer around each residence was drawn (N = 42857 census-block groups [19% of US block groups]). PA facilities, measured by national databases and satellite data, were linked with Geographic Information Systems technology to each respondent. Logistic-regression analyses tested the relationship of PA-related facilities with block-group socioeconomic status (SES) (at the community level) and the subsequent association of facilities with overweight and PA (at the individual level), controlling for population density. MAIN OUTCOME MEASURES. Outcome measures were overweight (BMI ≥ 95th percentile of the Centers for Disease Control and Prevention/National Center for Health Statistics growth curves) and achievement of ≥5 bouts per week of moderate-vigorous PA. RESULTS. Higher-SES block groups had a significantly greater relative odds of having 1 or more facilities. Low-SES and high-minority block groups were less likely to have facilities. Relative to zero facilities per block group, an increasing number of facilities was associated with decreased overweight and increased relative odds of achieving ≥5 bouts per week of moderate-vigorous PA. CONCLUSIONS. Lower-SES and high-minority block groups had reduced access to facilities, which in turn was associated with decreased PA and increased overweight. Inequality in availability of PA facilities may contribute to ethnic and SES disparities in PA and overweight patterns.

1,722 citations

References
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Journal ArticleDOI
09 Oct 2002-JAMA
TL;DR: The increases in the prevalences of obesity and overweight previously observed continued in 1999-2000, and increases occurred for both men and women in all age groups and for non-Hispanic whites, non- Hispanic blacks, and Mexican Americans.
Abstract: ContextThe prevalence of obesity and overweight increased in the United States between 1978 and 1991. More recent reports have suggested continued increases but are based on self-reported data.ObjectiveTo examine trends and prevalences of overweight (body mass index [BMI] ≥25) and obesity (BMI ≥30), using measured height and weight data.Design, Setting, and ParticipantsSurvey of 4115 adult men and women conducted in 1999 and 2000 as part of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population.Main Outcome MeasureAge-adjusted prevalence of overweight, obesity, and extreme obesity compared with prior surveys, and sex-, age-, and race/ethnicity–specific estimates.ResultsThe age-adjusted prevalence of obesity was 30.5% in 1999-2000 compared with 22.9% in NHANES III (1988-1994; P<.001). The prevalence of overweight also increased during this period from 55.9% to 64.5% (P<.001). Extreme obesity (BMI ≥40) also increased significantly in the population, from 2.9% to 4.7% (P = .002). Although not all changes were statistically significant, increases occurred for both men and women in all age groups and for non-Hispanic whites, non-Hispanic blacks, and Mexican Americans. Racial/ethnic groups did not differ significantly in the prevalence of obesity or overweight for men. Among women, obesity and overweight prevalences were highest among non-Hispanic black women. More than half of non-Hispanic black women aged 40 years or older were obese and more than 80% were overweight.ConclusionsThe increases in the prevalences of obesity and overweight previously observed continued in 1999-2000. The potential health benefits from reduction in overweight and obesity are of considerable public health importance.

6,523 citations

Journal ArticleDOI
01 Jan 2003-JAMA
TL;DR: Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status, and increases in obesity and diabetes continue in both sexes, all ages, all races, all educational levels, and all smoking levels.
Abstract: Context Obesity and diabetes are increasing in the United States. Objective To estimate the prevalence of obesity and diabetes among US adults in 2001. Design, Setting, and Participants Random-digit telephone survey of 195 005 adults aged 18 years or older residing in all states participating in the Behavioral Risk Factor Surveillance System in 2001. Main Outcome Measures Body mass index, based on self-reported weight and height and self-reported diabetes. Results In 2001 the prevalence of obesity (BMI ≥30) was 20.9% vs 19.8% in 2000, an increase of 5.6%. The prevalence of diabetes increased to 7.9% vs 7.3% in 2000, an increase of 8.2%. The prevalence of BMI of 40 or higher in 2001 was 2.3%. Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Compared with adults with normal weight, adults with a BMI of 40 or higher had an odds ratio (OR) of 7.37 (95% confidence interval [CI], 6.39-8.50) for diagnosed diabetes, 6.38 (95% CI, 5.67-7.17) for high blood pressure, 1.88 (95% CI,1.67-2.13) for high cholesterol levels, 2.72 (95% CI, 2.38-3.12) for asthma, 4.41 (95% CI, 3.91-4.97) for arthritis, and 4.19 (95% CI, 3.68-4.76) for fair or poor health. Conclusions Increases in obesity and diabetes among US adults continue in both sexes, all ages, all races, all educational levels, and all smoking levels. Obesity is strongly associated with several major health risk factors.

5,790 citations