Pathways to obesity: Identifying local, modifiable determinants of physical activity and diet

被引:127
作者
Stafford, Mai [1 ]
Cummins, Steven
Ellaway, Anne
Sacker, Amanda
Wiggins, Richard D.
Macintyre, Sally
机构
[1] UCL Med Sch, London, England
[2] Univ London, London, England
[3] MRC, Social & Publ Hlth Sci Unit, London W1N 4AL, England
[4] City Univ, Bangor, Gwynedd, Wales
基金
英国医学研究理事会; 英国经济与社会研究理事会;
关键词
deprivation; social capital; structural equation modelling; obesity; neighbourhood; health inequalities; UK;
D O I
10.1016/j.socscimed.2007.05.042
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
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. (C) 2007 Elsevier Ltd. All rights reserved.
引用
收藏
页码:1882 / 1897
页数:16
相关论文
共 94 条
[1]   Local services and amenities, neighborhood social capital, and health [J].
Altschuler, A ;
Somkin, CP ;
Adler, NE .
SOCIAL SCIENCE & MEDICINE, 2004, 59 (06) :1219-1229
[2]  
[Anonymous], 1989, STRUCTURAL EQUATIONS
[3]  
[Anonymous], 1988, HLTH DEPRIVATION INE
[4]   The effects of neighborhood conditions on perceptions of safety [J].
Austin, DM ;
Furr, LA ;
Spine, M .
JOURNAL OF CRIMINAL JUSTICE, 2002, 30 (05) :417-427
[5]   Obesity and the built environment [J].
Booth, KM ;
Pinkston, MM ;
Poston, WSC .
JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION, 2005, 105 (05) :S110-S117
[6]   Gender-specific disparities in obesity [J].
Borders, TF ;
Rohrer, JE ;
Cardarelli, KM .
JOURNAL OF COMMUNITY HEALTH, 2006, 31 (01) :57-68
[7]   Environmental and policy determinants of physical activity in the United States [J].
Brownson, RC ;
Baker, EA ;
Housemann, RA ;
Brennan, LK ;
Bacak, SJ .
AMERICAN JOURNAL OF PUBLIC HEALTH, 2001, 91 (12) :1995-2003
[8]  
Carstairs V., 1991, DEPRIVATION HLTH SCO
[9]   When being alone might be better: neighborhood poverty, social capital, and child mental health [J].
Caughy, MO ;
O'Campo, PJ ;
Muntaner, C .
SOCIAL SCIENCE & MEDICINE, 2003, 57 (02) :227-237
[10]   COMMUNITY-LEVEL COMPARISONS BETWEEN THE GROCERY STORE ENVIRONMENT AND INDIVIDUAL DIETARY PRACTICES [J].
CHEADLE, A ;
PSATY, BM ;
CURRY, S ;
WAGNER, E ;
DIEHR, P ;
KOEPSELL, T ;
KRISTAL, A .
PREVENTIVE MEDICINE, 1991, 20 (02) :250-261