Sex Matters: Impact of Neighborhood Physical and Social Environments on Adolescent Physical Activity and Obesity

Background: While few studies have reported community or neighborhood differences in health outcomes across sexes, increasing evidence suggests that neighborhood social and built environments can and do affect males and females differently.

Objective: To examine whether select physical and social neighborhood environments and their association with physical activity and obesity is moderated by sex.

Methods: We conducted multilevel analyses, weighted for sampling, among 9887 adolescents (age 12 to 20) in the georeferenced National Health and Nutrition Examination Survey, 1999-2006.

Results: Even after accounting for household physical activity and dietary behaviors, adolescents living in neighborhoods with greater unhealthy food availability and crime risk, and lower social capital reported significantly less physical activity and were more likely to be obese. Estimated effects of crime risk on physical activity and obesity were modified by gender. Girls living in neighborhoods with elevated crime risk were less likely to engage in vigorous to moderate weekly physical activity (adjusted odds ratio, aOR=0.74, 95% CI = 0.59, 0.92) and more likely to be obese (aOR=1.27, 95% CI = 1.02, 1.58) compared to girls living in neighborhoods with lower crime risk. However, crime risk was not associated with physical activity or obesity among boys.

Conclusion: Differences in physical activity and obesity among adolescents may be partially explained by characteristics of the neighborhood environment. Findings are consistent with the hypothesis that neighborhood environments may affect a range of behavioral and health outcomes. Furthermore, girls' physical activity and obesity levels may be more affected by the social environment than boys.