Sunday, April 29, 2012
Zip Code as Important as Genetic Code in Childhood Obesity
The original heading on this article -- reproduced above -- is a vast exaggeration. What was actually found was an assembly of mostly non-significant (>.05) relationships. And it was actually found that the environment around you had NO EFFECT on adults. It was only among children that some connection was observed.
Comparing Seattle and San Diego strikes me as a bit bizarre and creating large difficulties for control. I haven't bothered to look it up but as far as I am aware, San Diego has a much higher proportion of blacks and Hispanics than Seattle does. So how do you control for ethnicity? You could say, "We will look at whites only" but the whites in the two places might not be comparable. Due to the well known "white flight" phenomenon, many of the whites in San Diego might be "left behind" people in various ways.
I also believe that San Diego has America's largest population of retired admirals but although that is unlikely to have affected the results below, it is another warning that the populations of the two cities might be non comparable in a number of ways.
And even if we accept that the controls were adequate what do the results mean? How does "neighborhood" exert its effect? I doubt that the neighborhood itself does anything. But maybe people who live in nicer areas send their kids out to exercise of various sorts more. It may be an exercise effect rather than a neighborhood effect that we are looking at. That it is something like that is suggested by the fact that the environment had no effect on adult obesity
Nearly 18 percent of U.S. school-aged children and adolescents are obese, as the rate of childhood obesity has more than tripled in the past 30 years. The prevalence of obesity puts children at greater risk of developing heart disease, type 2 diabetes, stroke and other illnesses, and of suffering severe obesity as adults. New study results indicate that where a child lives, including factors such as the neighborhood's walkability, proximity to higher quality parks, and access to healthy food, has an important effect on obesity rates. Researchers found that children living in neighborhoods with favorable neighborhood environment attributes had 59 percent lower odds of being obese.
"Obesogenic Neighborhood Environments, Child and Parent Obesity: The Neighborhood Impact on Kids Study" was published in a special theme issue of the American Journal of Preventive Medicine. Led by Brian Saelens, PhD, of Seattle Children's Research Institute, this is among the first neighborhood environment studies to look at a combination of nutrition and physical activity environments and to assess children and their parents. It is also among the largest studies of its kind to use objective geographic information system (GIS) data to examine the physical activity and healthy food option attributes of a neighborhood related to obesity.
Researchers used GIS to assess Seattle and San Diego area neighborhoods' nutrition and physical activity environments. Nutrition environments were defined based on supermarket availability and concentration of fast food restaurants. Physical activity environments were defined based on environmental factors related to neighborhood walkability and at least one park with more or better amenities for children. Kids that lived in neighborhoods that were poorer in physical activity and nutrition environment had the highest rates of obesity -- almost 16 percent -- in the study. This figure is similar to the national average. On the flip side, only eight percent of children were obese in neighborhoods where physical activity and nutrition environments were positive.
"People think of childhood obesity and immediately think about an individual's physical activity and nutrition behaviors, but they do not necessarily equate obesity with where people live," said Dr. Saelens, who is also a professor of pediatrics at the University of Washington. "Everyone from parents to policymakers should pay more attention to zip codes because they could have a big impact on weight."
Fast food may not be as easy to come by in the Seattle area, based on the study. There were 3,474 fast food locations in San Diego County, as compared to 1,660 in King County, Wash. On a county-level block group average basis, San Diego had 2.0 fast food locations per block group, and King County had 1.1.
Numerous national health organizations have identified neighborhood environment and built environment, including healthy food and physical activity opportunities, as important factors in childhood obesity, including the Institute of Medicine and the Centers for Disease Control and Prevention. "Our data support recommendations from these groups that we need to change our environments to make them more supportive of physical activity and nutrition," said Saelens.
SOURCE
Posted by John J. Ray (M.A.; Ph.D.).