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

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

Abstract

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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  • Stafford, Mai & Cummins, Steven & Ellaway, Anne & Sacker, Amanda & Wiggins, Richard D. & Macintyre, Sally, 2007. "Pathways to obesity: Identifying local, modifiable determinants of physical activity and diet," Social Science & Medicine, Elsevier, vol. 65(9), pages 1882-1897, November.
  • Handle: RePEc:eee:socmed:v:65:y:2007:i:9:p:1882-1897
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    1. Altschuler, Andrea & Somkin, Carol P. & Adler, Nancy E., 2004. "Local services and amenities, neighborhood social capital, and health," Social Science & Medicine, Elsevier, vol. 59(6), pages 1219-1229, September.
    2. Austin, D. Mark & Furr, L. Allen & Spine, Michael, 2002. "The effects of neighborhood conditions on perceptions of safety," Journal of Criminal Justice, Elsevier, vol. 30(5), pages 417-427.
    3. Lochner, Kimberly A. & Kawachi, Ichiro & Brennan, Robert T. & Buka, Stephen L., 2003. "Social capital and neighborhood mortality rates in Chicago," Social Science & Medicine, Elsevier, vol. 56(8), pages 1797-1805, April.
    4. Giles-Corti, Billie & Donovan, Robert J., 2002. "The relative influence of individual, social and physical environment determinants of physical activity," Social Science & Medicine, Elsevier, vol. 54(12), pages 1793-1812, June.
    5. Neil Wrigley & Daniel Warm & Barrie Margetts, 2003. "Deprivation, Diet, and Food-Retail Access: Findings from the Leeds ‘Food Deserts' Study," Environment and Planning A, , vol. 35(1), pages 151-188, January.
    6. Mai Stafford & Mel Bartley & Amanda Sacker & Michael Marmot & Richard Wilkinson & Richard Boreham & Roger Thomas, 2003. "Measuring the Social Environment: Social Cohesion and Material Deprivation in English and Scottish Neighbourhoods," Environment and Planning A, , vol. 35(8), pages 1459-1475, August.
    7. Jerrett, Michael & Eyles, John & Cole, Donald, 1998. "Socioeconomic and environmental covariates of premature mortality in Ontario," Social Science & Medicine, Elsevier, vol. 47(1), pages 33-49, July.
    8. Wen, Ming & Cagney, Kathleen A. & Christakis, Nicholas A., 2005. "Effect of specific aspects of community social environment on the mortality of Individuals diagnosed with serious illness," Social Science & Medicine, Elsevier, vol. 61(6), pages 1119-1134, September.
    9. Brownson, R.C. & Baker, E.A. & Housemann, R.A. & Brennan, L.K. & Bacak, S.J., 2001. "Environmental and policy determinants of physical activity in the United States," American Journal of Public Health, American Public Health Association, vol. 91(12), pages 1995-2003.
    10. Rodwin, V.G. & Neuberg, L.G., 2005. "Infant mortality and income in 4 world cities: New York, London, Paris, and Tokyo," American Journal of Public Health, American Public Health Association, vol. 95(1), pages 86-90.
    11. Caughy, Margaret O'Brien & O'Campo, Patricia J. & Muntaner, Carles, 2003. "When being alone might be better: neighborhood poverty, social capital, and child mental health," Social Science & Medicine, Elsevier, vol. 57(2), pages 227-237, July.
    12. Franzini, Luisa & Caughy, Margaret & Spears, William & Eugenia Fernandez Esquer, Maria, 2005. "Neighborhood economic conditions, social processes, and self-rated health in low-income neighborhoods in Texas: A multilevel latent variables model," Social Science & Medicine, Elsevier, vol. 61(6), pages 1135-1150, September.
    13. Veenstra, Gerry, 2000. "Social capital, SES and health: an individual-level analysis," Social Science & Medicine, Elsevier, vol. 50(5), pages 619-629, March.
    14. Yen, I.H. & Kaplan, G.A., 1998. "Poverty area residence and changes in physical activity level: Evidence from the Alameda County Study," American Journal of Public Health, American Public Health Association, vol. 88(11), pages 1709-1712.
    15. Drukker, Marjan & Kaplan, Charles & Feron, Frans & van Os, Jim, 2003. "Children's health-related quality of life, neighbourhood socio-economic deprivation and social capital. A contextual analysis," Social Science & Medicine, Elsevier, vol. 57(5), pages 825-841, September.
    16. Wen, Ming & Browning, Christopher R. & Cagney, Kathleen A., 2003. "Poverty, affluence, and income inequality: neighborhood economic structure and its implications for health," Social Science & Medicine, Elsevier, vol. 57(5), pages 843-860, September.
    17. Cohen, Deborah A. & Finch, Brian K. & Bower, Aimee & Sastry, Narayan, 2006. "Collective efficacy and obesity: The potential influence of social factors on health," Social Science & Medicine, Elsevier, vol. 62(3), pages 769-778, February.
    18. Fullilove, M.T. & Héon, V. & Jimenez, W. & Parsons, C. & Green, L.L. & Fullilove, R.E., 1998. "Injury and anomie: Effects of violence in an inner-city community," American Journal of Public Health, American Public Health Association, vol. 88(6), pages 924-927.
    19. Macintyre, Sally & Ellaway, Anne & Cummins, Steven, 2002. "Place effects on health: how can we conceptualise, operationalise and measure them?," Social Science & Medicine, Elsevier, vol. 55(1), pages 125-139, July.
    20. Morland, K. & Wing, S. & Roux, A.D., 2002. "The contextual effect of the local food environment on residents' diets: The atherosclerosis risk in communities study," American Journal of Public Health, American Public Health Association, vol. 92(11), pages 1761-1767.
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    8. Santana, Paula & Santos, Rita & Nogueira, Helena, 2009. "The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal," Social Science & Medicine, Elsevier, vol. 68(4), pages 601-609, February.
    9. Maria Holst Algren & Carsten Kronborg Bak & Gabriele Berg-Beckhoff & Pernille Tanggaard Andersen, 2015. "Health-Risk Behaviour in Deprived Neighbourhoods Compared with Non-Deprived Neighbourhoods: A Systematic Literature Review of Quantitative Observational Studies," PLOS ONE, Public Library of Science, vol. 10(10), pages 1-17, October.
    10. Hastert, Theresa A. & Ruterbusch, Julie J. & Beresford, Shirley A.A. & Sheppard, Lianne & White, Emily, 2016. "Contribution of health behaviors to the association between area-level socioeconomic status and cancer mortality," Social Science & Medicine, Elsevier, vol. 148(C), pages 52-58.
    11. Sund, Erik Reidar & Jones, Andy & Midthjell, Kristian, 2010. "Individual, family, and area predictors of BMI and BMI change in an adult Norwegian population: Findings from the HUNT study," Social Science & Medicine, Elsevier, vol. 70(8), pages 1194-1202, April.
    12. 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.
    13. 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.
    14. Zhao, Zhenxiang & Kaestner, Robert & Xu, Xin, 2014. "Spatial mobility and environmental effects on obesity," Economics & Human Biology, Elsevier, vol. 14(C), pages 128-140.
    15. 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.
    16. Cannuscio, Carolyn C. & Hillier, Amy & Karpyn, Allison & Glanz, Karen, 2014. "The social dynamics of healthy food shopping and store choice in an urban environment," Social Science & Medicine, Elsevier, vol. 122(C), pages 13-20.
    17. Sven Voigtländer & Verena Vogt & Andreas Mielck & Oliver Razum, 2014. "Explanatory models concerning the effects of small-area characteristics on individual health," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 59(3), pages 427-438, June.
    18. Lowe, Melanie & Arundel, Jonathan & Hooper, Paula & Rozek, Julianna & Higgs, Carl & Roberts, Rebecca & Giles-Corti, Billie, 2020. "Liveability aspirations and realities: Implementation of urban policies designed to create healthy cities in Australia," Social Science & Medicine, Elsevier, vol. 245(C).
    19. 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.
    20. Zick, Cathleen D. & Smith, Ken R. & Fan, Jessie X. & Brown, Barbara B. & Yamada, Ikuho & Kowaleski-Jones, Lori, 2009. "Running to the Store? The relationship between neighborhood environments and the risk of obesity," Social Science & Medicine, Elsevier, vol. 69(10), pages 1493-1500, November.
    21. Davillas, Apostolos & Jones, Andrew M., 2020. "Regional inequalities in adiposity in England: distributional analysis of the contribution of individual-level characteristics and the small area obesogenic environment," Economics & Human Biology, Elsevier, vol. 38(C).

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