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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.

Suggested Citation

  • 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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    References listed on IDEAS

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    1. 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.
    2. 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.
    3. 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.
    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. Zhao, Zhenxiang & Kaestner, Robert & Xu, Xin, 2014. "Spatial mobility and environmental effects on obesity," Economics & Human Biology, Elsevier, vol. 14(C), pages 128-140.
    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.
    7. 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.
    8. 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.
    9. 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.
    10. Ivory, Vivienne C. & Collings, Sunny C. & Blakely, Tony & Dew, Kevin, 2011. "When does neighbourhood matter? Multilevel relationships between neighbourhood social fragmentation and mental health," Social Science & Medicine, Elsevier, vol. 72(12), pages 1993-2002, June.
    11. 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.
    12. Zhao, Zhenxiang & Kaestner, Robert, 2010. "Effects of urban sprawl on obesity," Journal of Health Economics, Elsevier, vol. 29(6), pages 779-787, December.
    13. 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.
    14. Greves Grow, H. Mollie & Cook, Andrea J. & Arterburn, David E. & Saelens, Brian E. & Drewnowski, Adam & Lozano, Paula, 2010. "Child obesity associated with social disadvantage of children's neighborhoods," Social Science & Medicine, Elsevier, vol. 71(3), pages 584-591, August.
    15. Nogueira, Helena Guilhermina, 2010. "Deprivation amplification and health promoting resources in the context of a poor country," Social Science & Medicine, Elsevier, vol. 70(9), pages 1391-1395, May.
    16. 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.

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