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Linking Childhood Obesity to the Built Environment: A Multi-level Analysis of Home and School Neighbourhood Factors Associated With Body Mass Index

  • Quantitative Research
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Abstract

Objectives

This study examines environmental factors associated with BMI (body mass index) levels among adolescents with the aim of identifying potential interventions for reducing childhood obesity.

Methods

Students (n=1,048) aged 10–14 years at 28 schools in London, ON, completed a survey providing information on age, sex, height, weight, home address, etc., which was used to construct age-sex adjusted BMI z-scores. The presence of recreation opportunities, fast-food outlets and convenience stores was assessed using four areal units around each participant’s home and school neighbourhood: “circular buffers” encompassing territory within a straight-line distance of 500 m and 1000 m; and “network buffers” of 500 m and 1000 m measured along the street network. School neighbourhoods were also assessed using school-specific “walksheds”. Multilevel structural equation modeling techniques were employed to simultaneously test the effects of school-environment (Level 2) and home-environment (Level 1) predictors on BMI z-scores.

Results

Most participants (71%) had a normal BMI, 16.9% were overweight, 7.6% were obese, and 4.6% were considered underweight. Multilevel analyses indicated that built environment characteristics around children’s homes and schools had a modest but significant effect on their BMI. The presence of public recreation opportunities within a 500 m network distance of home was associated with lower BMI z-scores (p<0.05), and fast-food outlets within the school walkshed was associated with higher BMI z-scores (p<0.05).

Conclusion

Interventions and policies that improve children’s access to publicly provided recreation opportunities near home and that mitigate the concentration of fast-food outlets close to schools may be key to promoting healthy lifestyles and reducing childhood obesity.

Résumé

Objectifs

Notre étude porte sur les facteurs environnementaux associés à l’IMC (indice de masse corporelle) d’adolescents en vue de cerner des interventions possibles pour réduire l’obésité infantile.

Méthode

Des élèves (n=1 048) de 10 à 14 ans fréquentant 28 écoles de London, en Ontario, ont rempli un questionnaire sur leur âge, leur sexe, leur taille, leur poids, leur adresse personnelle, etc., lequel a servi à construire des écarts Z ajustés selon l’âge et le sexe pour l’IMC. La présence de possibilités de loisir, d’établissements de restauration rapide et de dépanneurs a été évaluée à l’aide de quatre unités de surface autour du domicile et du quartier scolaire de chaque participant: des «zones tampons circulaires» englobant le territoire sur une distance entre 500 et 1000 m en ligne droite; et des «zones tampon de réseau» de 500 à 1000 m mesurées le long du réseau des rues. Les quartiers scolaires ont aussi été évalués à l’aide des «bassins de marche» propres à l’école. Une modélisation multiniveaux par équations structurelles a servi à évaluer simultanément les effets de prédicteurs des écarts Z de l’IMC liés à l’environnement scolaire (niveau 2) et au milieu de vie (niveau 1).

Résultats

La plupart des participants (71 %) avaient un IMC normal, 16,9 % étaient en surpoids, 7,6 % étaient obèses, et 4,6 % étaient considérés comme étant de poids insuffisant. Des analyses multiniveaux ont montré que les caractéristiques du milieu bâti autour du domicile et de l’école des enfants avaient un effet mineur mais significatif sur leur IMC. La présence d’installations de loisir publiques dans un réseau de 500 m du domicile était associée à des écarts Z d’IMC inférieurs (p<0,05), et la présence d’établissements de restauration rapide dans le bassin de marche de l’école était associée à des écarts Z d’IMC supérieurs (p<0,05).

Conclusion

Les interventions et les politiques qui améliorent l’accès des enfants à des installations de loisir publiques près de chez eux et qui atténuent la concentration des établissements de restauration rapide près des écoles pourraient être la clé du succès pour promouvoir les modes de vie sains et réduire l’obésité infantile.

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Author information

Authors and Affiliations

  1. Human Environments Analysis Laboratory, Department of Geography, University of Western Ontario, London, ON, N6A SC2, 1151 Richmond St, Canada

    Jason A. Gilliland PhD (Scientist), Claudia Y. Rangel MA, Martin A. Healy MSc & Janet E. Loebach MEDes

  2. School of Health Studies and Department of Paediatrics, University of Western Ontario, London, ON, Canada

    Jason A. Gilliland PhD (Scientist)

  3. Children’s Health Research Institute & Lawson Health Research Institute, London, ON, Canada

    Jason A. Gilliland PhD (Scientist) & Piotr Wilk PhD

  4. School of Occupational Therapy, University of Western Ontario, London, ON, Canada

    Patricia Tucker PhD

  5. Department of Geography & Program in Planning, University of Toronto, Toronto, ON, Canada

    Paul M. Hess PhD

  6. Department of Health & Kinesiology, The University of Texas at San Antonio, San Antonio, TX, Canada

    Meizi He PhD

  7. School of Health Studies, University of Western Ontario, London, ON, Canada

    Jennifer D. Irwin PhD

  8. Department of Paediatrics and Department of Epidemiology & Biostatistics, University of Western Ontario, London, ON, Canada

    Piotr Wilk PhD

Authors
  1. Jason A. Gilliland PhD
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  2. Claudia Y. Rangel MA
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  3. Martin A. Healy MSc
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  4. Patricia Tucker PhD
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  5. Janet E. Loebach MEDes
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  6. Paul M. Hess PhD
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  7. Meizi He PhD
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  8. Jennifer D. Irwin PhD
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  9. Piotr Wilk PhD
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Corresponding author

Correspondence to Jason A. Gilliland PhD.

Additional information

Acknowledgements: This study was supported by research grants from the Heart and Stroke Foundation of Canada, the Green Shield Canada Foundation and the Canadian Institutes of Health Research’s Institutes of Human Development, Child and Youth Health, and Nutrition, Metabolism and Diabetes

Conflict of Interest: None to declare

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Gilliland, J.A., Rangel, C.Y., Healy, M.A. et al. Linking Childhood Obesity to the Built Environment: A Multi-level Analysis of Home and School Neighbourhood Factors Associated With Body Mass Index. Can J Public Health 103 (Suppl 3), S15–S21 (2012). https://doi.org/10.1007/BF03403830

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  • DOI: https://doi.org/10.1007/BF03403830

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