183857 Built environment characteristics and obesity in underserved populations: A systematic review

Wednesday, October 29, 2008

Gina S. Lovasi, PhD , Institute for Social and Economic Research and Policy, Columbia University, New York, NY
Malo A. Hutson, PhD , City & Regional Planning, University of California, Berkeley, Berkeley, CA
Monica Guerra, BA , Department of Urban Planning, University of Michigan, Ann Arbor, MI
Kathryn M. Neckerman, PhD , Institute for Social and Economic Research and Policy, Columbia University, New York, NY
Introduction: In the United States, health disparities in obesity and obesity-related illnesses have been identified and targeted for elimination. Our objective was to better understand whether obesity-related health disparities could be explained by differential exposure to obesigenic environments.

Methods: We conducted a systematic review of the published scientific literature, screening for studies with relevance to underserved individuals or areas, which were identified by low socioeconomic status, black race, or Hispanic ethnicity. We identified 34 studies published between 2001 and 2007 which either (1) separately estimated the obesity-related effects of the built environment for one or more underserved groups or (2) described the relative exposure underserved groups had to potentially obesigenic built environment characteristics.

Results: Based on available evidence, built environment characteristics were categorized as relevant to the food environment, urban form (walkable versus sprawling patterns), places to exercise, and safety/aesthetics. When considering the obesity-related effects of built environment characteristics, we found the strongest support for the importance of food stores (supermarkets instead of smaller grocery/convenience stores), places to exercise, and safety as potentially beneficial for underserved groups. We also found that underserved groups are likely to be at a disadvantage with respect to food stores, aesthetic problems, and traffic or crime-related safety.

Conclusion: One potential strategy to reduce obesity would involve changing the built environment to be more supportive of physical activity and a healthy diet. Based on our review, increasing supermarket access and safety may be especially promising strategies to reduce obesity-related health disparities.

Learning Objectives:
1. Recognize which built environment characteristics could help to explain obesity-related health disparities in the US 2. Discuss built environment characteristics that could support physical activity and a healthy diet within historically disadvantaged populations

Keywords: Underserved Populations, Obesity

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I've lead the effort to review and describe the published literature for this abstract and the corresponding manuscript, in collaboration with my coauthors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.