Characteristics of Walkable Built Environments and BMI z -Scores in Children: Evidence from a Large Electronic Health Record Database

• DOI: 10.1289/ehp.1307704
• Publication Date: 2014-09-23T16:02:36Z
• Authors: Dustin T. Duncan; Mona Sharifi; Steven J. Melly; Richard Marshall; Thomas D. Sequist; Sheryl L. Rifas-S...; Elsie M. Taveras
• Keywords: Quartile; Walkability; Level design

Background: Childhood obesity remains a prominent public health problem. Walkable built environments may prevent excess weight gain.Objectives: We examined the association of walkable environment characteristics with body mass index (BMI) z-score among large sample children and adolescents.Methods: used geocoded residential address data from electronic records 49,770 adolescents 4 to < 19 years age seen at 14 pediatric practices Harvard Vanguard Medical Associates August 2011 through 2012. eight geographic information system (GIS) variables characterize environments. Outcomes were BMI most recent visit change earliest available (2008–2011) (2011–2012) visit. Multivariable models adjusted for child age, sex, race/ethnicity, neighborhood median household income.Results: In multivariable cross-sectional models, living in closer proximity recreational open space was associated lower z-score. For example, who lived closest (quartile 1) nearest had (β = –0.06; 95% CI: –0.08, –0.03) compared those farthest away 4; reference). Living neighborhoods fewer spaces less density, traffic sidewalk completeness, intersection density higher an increase over time.Conclusions: Overall, that walkability z-scores children. Modifying existing make them more reduce childhood obesity.Citation: Duncan DT, Sharifi M, Melly SJ, Marshall R, Sequist TD, Rifas-Shiman SL, Taveras EM. 2014. Characteristics children: evidence record database. Environ Health Perspect 122:1359–1365; http://dx.doi.org/10.1289/ehp.1307704