Physical activity-oriented zoning and walkable community associations with adolescent obesity

Background: Obesity is a multi-faceted problem requiring solutions from multiple sectors of influence, including land use/zoning. Recent research documented that adolescent obesity is lower in more walkable communities. A key factor influencing community walkability is how the community is designed/zoned to support physical activity (PA). This presentation examines the association of zoning/land use policies, community walkability, and adolescent obesity.

Methods:  Zoning/land use ordinances were obtained and street segments were audited through observational research in 154 catchments surrounding schools attended by nationally-representative samples of secondary school students in 2010. A 6-item scale captured PA-supportive zoning requirements and a 10-item scale captured on-the-ground street-level infrastructure supportive of PA (both scales contained items related to sidewalks, bike lanes, trails, etc.). Adolescent obesity was derived from student self-reported height and weight data obtained through the Monitoring the Future survey conducted in schools located in the catchments. Multi-level mediation analyses examined associations between PA-oriented zoning, community walkability, and adolescent obesity, controlling for catchment- and individual-level factors.

Results: PA-oriented zoning was associated with higher community walkability (β=0.56, 95% CI=0.30, 0.82). PA-oriented zoning (β=-0.06, 95% CI=-0.109, -0.003) and more walkable communities (β=-0.05, 95% CI=-0.08,-0.02) were directly associated with lower adolescent obesity prevalence. Mediation analyses showed a fully-mediated association path (95% CI: -0.57, -0.010): PA-oriented zoning worked through increased community walkability to associate with significantly lower adolescent obesity.

Conclusions: Zoning/land use policies are an important policy tool for communities seeking to develop more walkable communities supportive of PA and, collectively, they may ultimately help to reduce adolescent obesity.