Physical activity friendliness of neighborhoods, weight status, and blood pressure in children

Physical activity friendliness refers to features of the built environment that are conducive to physical activity or present obstacles to it. A cross-sectional prevalence study of cardiovascular risk factors with children in kindergarten through sixth grade was conducted in three schools in an urban area in southeastern U.S. Census block groups (n=17) in which the children resided were selected for environmental audit of physical activity friendliness using the St. Louis Environmental Audit. Data from the 2000 Census at the block group level included percent of families with children living in poverty and percent of adults with more than a high school education. It was hypothesized that higher physical activity friendliness scores would be associated with 1) lower systolic and diastolic blood pressure, 2) lower BMI, and 3) lower levels of poverty and higher levels of education. The sample of 934 children was 70% Hispanic, 24% African American; 29% had >/= 95th percentile of BMI and 9.1% had prehypertension or hypertension. Mixed effects regression models were used to control for clustering effects of children's risk factors within block groups. Findings partially supported the first hypothesis; medium versus higher scores on physical activity friendliness were associated with higher diastolic blood pressure. Hypothesis 2 that higher physical activity friendliness scores would be associated with lower BMI was supported. Hypothesis 3 was supported; higher physical activity friendliness scores were associated with lower poverty and higher educational levels. Our findings can facilitate identifying appropriate environmental targets for interventions to prevent obesity and hypertension in children.