| Neighborhood Food Environment and Walkability Predict Obesity in New York City Andrew Rundle,1 Kathryn M. Neckerman,2 Lance Freeman,3 Gina S. Lovasi,4 Marnie Purciel,2 James Quinn,2 Catherine Richards,1 Neelanjan Sircar,2 and Christopher Weiss2 1Department of Epidemiology, Mailman School of Public Health, 2Institute for Social and Economic Research and Policy, 3Urban Planning, Graduate School of Architecture, Planning, and Preservation, and 4Robert Wood Johnson Foundation Health and Society Scholars Program, Columbia University, New York, New York, USA Abstract
Background: Differences in the neighborhood food environment may contribute to disparities in obesity. Objectives: The purpose of this study was to examine the association of neighborhood food environments with body mass index (BMI) and obesity after control for neighborhood walkability. Methods: This study employed a cross-sectional, multilevel analysis of BMI and obesity among 13,102 adult residents of New York City. We constructed measures of the food environment and walkability for the neighborhood, defined as a half-mile buffer around the study subject’s home address. Results: Density of BMI-healthy food outlets (supermarkets, fruit and vegetable markets, and natural food stores) was inversely associated with BMI. Mean adjusted BMI was similar in the first two quintiles of healthy food density (0 and 1.13 stores/km2, respectively) , but declined across the three higher quintiles and was 0.80 units lower [95% confidence interval (CI) , 0.27–1.32] in the fifth quintile (10.98 stores/km2) than in the first. The prevalence ratio for obesity comparing the fifth quintile of healthy food density with the lowest two quintiles combined was 0.87 (95% CI, 0.78–0.97) . These associations remained after control for two neighborhood walkability measures, population density and land-use mix. The prevalence ratio for obesity for the fourth versus first quartile of population density was 0.84 (95% CI, 0.73–0.96) and for land-use mix was 0.91 (95% CI, 0.86–0.97) . Increasing density of food outlets categorized as BMI-unhealthy was not significantly associated with BMI or obesity. Conclusions: Access to BMI-healthy food stores is associated with lower BMI and lower prevalence of obesity. Key words: neighborhood studies, obesity, retail food environment, walkability. Environ Health Perspect 117:442–447 (2009) . doi:10.1289/ehp.11590 available via http://dx.doi.org/ [Online 2 October 2008]
Address correspondence to A. Rundle, Department of Epidemiology, Columbia University, 722 West 168th St., Room 730, New York, NY 10032 USA. Telephone: (212) 305-7619. Fax: (212) 305-9413. E-mail: agr3@columbia.edu This work was supported by National Institute of Environmental Health Sciences grant 5R01ES014229. The authors declare they have no competing financial interests. Received 17 April 2008 ; accepted 1 October 2008.
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