Effects of food and physical activity environments on children's weight status in low-income urban neighborhoods

Background. Design of effective community strategies to prevent and reduce obesity requires a richer understanding of the specific contributions made by the food and physical activity environments to children's weight status. Methods. Data were collected from households with children ages 3-18 using a random-digit-dial survey in four low-income cities with predominantly minority populations in New Jersey. Respondents weighed and measured themselves and all children in the household using CDC guidelines. Objectively classified food and physical activity outlets surrounding a household were geocoded to develop measures of varied degrees of proximity. Results. Almost all( 96%) children lived within ½ mile of unhealthy food outlets such as convenience stores and limited service restaurants, 38.5% lived within ½ mile of a supermarket and 88.8% lived within ½ mile of a park. Proximity to convenience stores and parks showed significant bivariate associations with child's weight status and also proved to be robust predictors in multivariate models. A child's odds of being overweight or obese were significantly higher if they lived within ¼ mile of a convenience store (OR = 1.79, 95% CI: 1.00-3.19) and significantly lower if they lived within ½ mile of a park (OR = 0.44, 95% CI: 0.23-0.82). Discussion. Isolating independent relationships between the neighborhood environment and child weight status is necessary for the optimal allocation of community-based obesity prevention resources. Our findings offer a basis for improving the effectiveness of such targeted interventions by singling out convenience stores and parks as likely influential contributors to childhood obesity in urban communities.