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Development of a national childhood obesogenic environment index in the United States: differences by region and rurality
Journal article   Open access   Peer reviewed

Development of a national childhood obesogenic environment index in the United States: differences by region and rurality

Andrew T. Kaczynski, Jan M. Eberth, Ellen W. Stowe, Marilyn E. Wende, Angela D. Liese, Alexander C. McLain, Charity B. Breneman and Michele J. Josey
The international journal of behavioral nutrition and physical activity, v 17(1), 83
02 Jul 2020
DOI: https://doi.org/10.1186/s12966-020-00984-x
PMID: 32615998
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1186/s12966-020-00984-xView
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Nutrition & Dietetics Physiology Science & Technology
Background: Diverse environmental factors are associated with physical activity (PA) and healthy eating (HE) among youth. However, no study has created a comprehensive obesogenic environment index for children that can be applied at a large geographic scale. The purpose of this study was to describe the development of a childhood obesogenic environment index (COEI) at the county level across the United States. Methods: A comprehensive search of review articles (n = 20) and input from experts (n = 12) were used to identify community-level variables associated with youth PA, HE, or overweight/obesity for potential inclusion in the index. Based on strength of associations in the literature, expert ratings, expertise of team members, and data source availability, 10 key variables were identified - six related to HE (# per 1000 residents for grocery/superstores, farmers markets, fast food restaurants, full-service restaurants, and convenience stores; as well as percentage of births at baby (breastfeeding)-friendly facilities) and four related to PA (percentage of population living close to exercise opportunities, percentage of population < 1 mile from a school, a composite walkability index, and number of violent crimes per 1000 residents). Data for each variable for all counties in the U.S. (n = 3142) were collected from publicly available sources. For each variable, all counties were ranked and assigned percentiles ranging from 0 to 100. Positive environmental variables (e.g., grocery stores, exercise opportunities) were reverse scored such that higher values for all variables indicated a more obesogenic environment. Finally, for each county, a total obesogenic environment index score was generated by calculating the average percentile for all 10 variables. Results: The average COEI percentile ranged from 24.5-81.0 (M = 50.02, s.d. = 9.01) across US counties and was depicted spatially on a choropleth map. Obesogenic counties were more prevalent (F = 130.43, p < .0001) in the South region of the U.S. (M = 53.0, s.d. = 8.3) compared to the Northeast (M = 43.2, s.d. = 6.9), Midwest (M = 48.1, s.d. = 8.5), and West (M = 48.4, s.d. = 9.8). When examined by rurality, there were also significant differences (F = 175.86, p < .0001) between metropolitan (M = 46.5, s.d. = 8.4), micropolitan (M = 50.3, s.d. = 8.1), and rural counties (M = 52.9, s.d. = 8.8) across the U.S. Conclusion: The COEI can be applied to benchmark obesogenic environments and identify geographic disparities and intervention targets. Future research can examine associations with obesity and other health outcomes.

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37 citations in Web of Science
36 citations in Scopus

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UN Sustainable Development Goals (SDGs)

This publication has contributed to the advancement of the following goals:

#3 Good Health and Well-Being

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Web of Science research areas
Nutrition & Dietetics
Physiology
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