Key points are not available for this paper at this time.
PURPOSE: To identify perceived indicators of the physical environment associated with obesity in rural communities. DESIGN: Cross-sectional telephone survey. SETTING: Thirteen communities in rural Missouri, Tennessee, and Arkansas, 2003. SUBJECTS: A total of 2510 adults completed the survey and 2210 respondents were included in the analysis (74% female, 93% white, and 27% obese). MEASURES: The 106-item survey measured perceptions of the neighborhood environment (recreational facilities, land use, transportation/safety, aesthetics, and food environment) and health-related behaviors. The primary outcome was obese (body mass index BMI > or = 30 kg/mn2) vs. normal weight (BMI = 18.5-24.9 kg/m2). ANALYSIS: Logistic regression was used to control for age, gender and education. RESULTS: Several indicators of the perceived neighborhood environment were associated with being obese (adjusted odds ratio 95% confidence interval), including furthest distance to the nearest recreational facility (1.8 1.3-2.4), unpleasant community for physical activity (1.8 1.3-2.6), feeling unsafe from crime (2.1 1.5-2.9) or traffic (1.7 1.2-2.3), and few nonresidential destinations (1.4 1.0-1.9). Distance to recreational facilities and crime safety remained significant in the multivariate model, along with dietary-fat intake, sedentary behavior, and moderate/vigorous physical activity. CONCLUSION: This study adds to a growing evidence base of environmental correlates of obesity and makes a unique contribution regarding rural communities. If causality is established, environmental interventions that target obesogenic neighborhood features may reduce the prevalence of obesity on a population level.
Boehmer et al. (Sat,) studied this question.