Journal of Urban Health

, Volume 90, Issue 3, pp 442–463

Area-Based Variations in Obesity Are More than a Function of the Food and Physical Activity Environment

Area-based Variations in Obesity

DOI: 10.1007/s11524-012-9715-5

Cite this article as:
Oka, M., Link, C.L. & Kawachi, I. J Urban Health (2013) 90: 442. doi:10.1007/s11524-012-9715-5


This study examines the area-based variations in obesity from a community-based epidemiologic survey of Boston, MA, USA, using a geographic information system and multilevel modeling techniques. A combination of quantitative and qualitative methods was used to assess whether a function of the food and the physical activity (PA) environment can explain the body weight of residents. First, a series of multilevel analyses was conducted after accounting for the well-established individual determinants and capturing a wide range of environmental attributes to represent a more realistic portrayal of urban typology. Second, the results of multilevel analysis were framed into the theoretical model of area-based variations in obesity to qualitatively summarize the association of contextual factors with the body weight of residents. Based on the overall correlation, the area-based variations defined by a function of the food and PA environment seem to be insufficient in explaining the body weight of residents. By testing the cross-level interactions of gender and race/ethnicity with contextual factors, the results suggest that the concept of area-based variations in obesity will have to consider how residents behave differently within a given environment. More research is needed to better understand the contextual determinants of obesity so as to put forth population-wide interventions.


Body mass index (BMI)Food environmentObesityPhysical activity (PA) EnvironmentMultilevel analysisMultilevel analysisNeighborhood characteristics

Copyright information

© The New York Academy of Medicine 2012

Authors and Affiliations

  1. 1.Advanced Studies Program, Graduate School of DesignHarvard UniversityCambridgeUSA
  2. 2.New England Research InstitutesWatertownUSA
  3. 3.Department of Society, Human Development, and Health, School of Public HealthHarvard UniversityBostonUSA