The urban built environment and obesity in New York City: A multilevel analysis

Purpose. To examine whether urban form is associated with body size within a densely-settled city. Design. Cross-sectional analysis using multilevel modeling to relate body mass index (BMI) to built environment resources. Setting. Census tracts (n = 1989) within the five boroughs of New York City. Subjects. Adult volunteers (n = 13,102) from the five boroughs of New York City recruited between January 2000 and December 2002. Measures. The dependent variable was objectively-measured BMI. Independent variables included land use mix; bus and subway stop density; population density; and intersection density. Covariates included age, gender, race, education, and census tract-level poverty and race/ethnicity. Analysis. Cross-sectional multilevel analyses. Results. Mixed land use (Beta = -. 55, p <. 01), density of bus stops (Beta = 01, p < 01) and subway stops (Beta = -. 06, p <. 01), and population density (Beta = 25, p < 001), but not intersection density (Beta = -. 002) were significantly inversely associated with BMI after adjustment for individual- and neighborhood-level sociodemographic characteristics. Comparing the 90th to the 10th percentile of each built environment variable, the predicted adjusted difference in BMI with increased mixed land use was -.41 units, with bus stop density was -.33 units, with subway stop density was -.34 units, and with population density was -.86 units. Conclusion. BMI is associated with built environment characteristics in New York City.