Online Program

Relationship between measures of urban form and body mass index in non-urban diabetic adults: Results from Vermont

Wednesday, November 6, 2013

Benjamin Littenberg, MD, General Internal Medicine - Research, College of Medicine, University of Vermont, Burlington, VT
Austin Troy, PhD, School of Natural Resources, University of Vermont
Objectives: We analyzed the relationship between measures of urban form and body mass index (BMI) across a settlement gradient ranging from rural areas to small regional cities. Methods: Using data from the Vermont Diabetes Information System on 610 adults with diabetes, we regressed BMI against several measures of urban form, controlling for a number of potential confounders as well as spatial autocorrelation. Results: We found a strong positive correlation between BMI and the density of commercial buildings within 250 m of the subject's home. There was about a 1 kg/m2 increase in BMI for each additional commercial facility per hectare. However, location within a designated downtown district was associated with a reduction in BMI of 1.2 kg/m2. Conclusions: The positive association of BMI and density is contrary to much of the previous literature and suggests a different mechanism in a predominantly rural and exurban region like Vermont than in the large metropolitan areas where most of the previous research was conducted. This association may relate to rural residents' greater access to outdoor recreation opportunities or to the physical requirements associated with rural property maintenance. The effect of downtown location suggests that additional design characteristics beyond density—possibly mix of uses, pedestrian infrastructure, or difficulty in parking— result in downtowns being associated with lower BMI.

Learning Areas:

Chronic disease management and prevention
Environmental health sciences

Learning Objectives:
Define characteristics of the built environment that contribute to obesity.

Keyword(s): Obesity, Environment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was principal investigator of the project that collected the data. I posed the research question and performed some of the analyses. I have extensive clinical and research experience in managing and preventing chronic disease.
Any relevant financial relationships? Yes

Name of Organization Clinical/Research Area Type of relationship
Patient Engagement Systems Chronic Care Advisory Committee/Board and Stock Ownership

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.