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Pathways to obesity: Identifying local, modifiable determinants of physical activity and diet


Author Info

  • Stafford, Mai
  • Cummins, Steven
  • Ellaway, Anne
  • Sacker, Amanda
  • Wiggins, Richard D.
  • Macintyre, Sally


Many studies document small area inequalities in morbidity and mortality and show associations between area deprivation and health. However, few studies unpack the "black box" of area deprivation to show which specific local social and physical environmental characteristics impact upon health, and might be amenable to modification. We theorised a model of the potential causal pathways to obesity and employed path analysis using a rich data set from national studies in England and Scotland to test the model empirically. Significant associations between obesity and neighbourhood disorder and access to local high street facilities (local shops, financial services and health-related stores found in a typical small UK town) were found. There was a tendency for lower levels of obesity in areas with more swimming pools and supermarkets. In turn, policing levels, physical dereliction and recorded violent crime were associated with neighbourhood disorder. The analysis identifies several factors that are associated with (and are probably determinants of) obesity and which are outside the standard remit of the healthcare sector. They highlight the role that public and private sector organisations have in promoting the nation's health. Public health professionals should seek to work alongside or within these organisations to capitalise on opportunities to improve health.

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Bibliographic Info

Article provided by Elsevier in its journal Social Science & Medicine.

Volume (Year): 65 (2007)
Issue (Month): 9 (November)
Pages: 1882-1897

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Handle: RePEc:eee:socmed:v:65:y:2007:i:9:p:1882-1897

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Keywords: Deprivation Social capital Structural equation modelling Obesity Neighbourhood Health inequalities UK;


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Cited by:
  1. Zhenxiang Zhao & Robert Kaestner, 2009. "Effects of Urban Sprawl on Obesity," NBER Working Papers 15436, National Bureau of Economic Research, Inc.
  2. Macdonald, Elizabeth & Sanders, Rebecca & Supawanich, Paul, 2008. "The Effects of Transportation Corridors' Roadside Design Features on User Behavior and Safety, and Their Contributions to Health, Environmental Quality, and Community Economic Vitality: a Literature R," University of California Transportation Center, Working Papers qt12047015, University of California Transportation Center.
  3. Hoehner, Christine M. & Handy, Susan L. & Yan, Yan & Blair, Steven N. & Berrigan, David, 2011. "Association between neighborhood walkability, cardiorespiratory fitness and body-mass index," Social Science & Medicine, Elsevier, vol. 73(12), pages 1707-1716.
  4. Nagata, Jason M. & Valeggia, Claudia R. & Barg, Frances K. & Bream, Kent D.W., 2009. "Body mass index, socio-economic status and socio-behavioral practices among Tz'utujil Maya women," Economics & Human Biology, Elsevier, vol. 7(1), pages 96-106, March.
  5. Badland, Hannah & Whitzman, Carolyn & Lowe, Melanie & Davern, Melanie & Aye, Lu & Butterworth, Iain & Hes, Dominique & Giles-Corti, Billie, 2014. "Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health," Social Science & Medicine, Elsevier, vol. 111(C), pages 64-73.
  6. Caspi, Caitlin E. & Kawachi, Ichiro & Subramanian, S.V. & Tucker-Seeley, Reginald & Sorensen, Glorian, 2013. "The social environment and walking behavior among low-income housing residents," Social Science & Medicine, Elsevier, vol. 80(C), pages 76-84.


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