ABSTRACT
BACKGROUND: Little is known about the associations between natural amenities, recreation facility density, and obesity, at a national level. Therefore, the purpose of this paper was to examine associations between county-level natural amenities, density of recreation facilities, and obesity prevalence among United States counties. METHODS: Data were obtained from a compilation of sources within the United States Department of Agriculture Economic Research Service Food Environment Atlas. Independent variables of interest were the natural amenities scale and recreation facilities per capita. The dependent variable was county-level obesity prevalence. Potential covariates included a measure of county-level percent Black residents, percent Hispanic residents, median age, and median household income. All models were stratified by population loss, persistent poverty, and metro status. Multilevel linear regression models were used to examine the association between obesity and natural amenities and recreation facilities, with "state" as a random effects second level variable. RESULTS: There were statistically significant negative associations between percent obesity and 1) natural amenities and 2) recreation facilities per capita. CONCLUSIONS: Future research should examine environmental and policy changes to increase recreation facilities and enhance accessible natural amenities to decrease obesity rates.
Subject(s)
Environment Design , Leisure Activities , Obesity/epidemiology , Recreation , Residence Characteristics , Black or African American/psychology , Black or African American/statistics & numerical data , Female , Hispanic or Latino/psychology , Hispanic or Latino/statistics & numerical data , Humans , Linear Models , Local Government , Male , Middle Aged , Prevalence , Rural Population , Social Environment , Socioeconomic Factors , United States/epidemiology , United States Department of Agriculture/statistics & numerical data , Urban PopulationABSTRACT
PURPOSE: To examine associations between county-level natural amenities, physical activity (PA), and body mass index (BMI). DESIGN AND SETTING: Cross-sectional study among 100 North Carolina counties. MEASURES: We obtained percentage of county residents meeting PA criteria and county-wide means for reported height and weight from the North Carolina Behavioral Risk Factor Surveillance System, combining years 2003, 2005, and 2007. The county natural amenities scale was the independent variable. Potential county-level covariates were percentage rural, percentage black, median age, and median household income (Census 2000). ANALYSIS: We conducted weighted bivariate and linear regression analyses to examine relationships between natural amenities, aggregate PA, and aggregate BMI. RESULTS: BMI and natural amenities were negatively associated (parameter estimate â=â -.13 (.06), p â=â .03). When percentage meeting PA criteria was included, the parameter estimate attenuated 15%. CONCLUSION: There was an inverse relationship between natural amenities and BMI, partially mediated by PA.
