Advertisement

Journal of Immigrant and Minority Health

, Volume 20, Issue 4, pp 854–864 | Cite as

Examining the Role of Income Inequality and Neighborhood Walkability on Obesity and Physical Activity among Low-Income Hispanic Adults

  • Samuel D. TowneJr.
  • Michael L. Lopez
  • Yajuan Li
  • Matthew Lee Smith
  • Judith L. Warren
  • Alexandra E. Evans
  • Marcia G. Ory
Original Paper

Abstract

Obesity is a major public health issue affecting rising medical costs and contributing to morbidity and premature mortality. We aimed to identify factors that may play a role in obesity and physical activity at the individual and environmental/neighborhood levels. We analyzed data from an adult sample who were parents of students enrolled in a school-based health and wellness program. The sample was restricted to those who were Hispanic and whose children were on free/reduced lunch (n = 377). Dependent variables: body mass index (BMI); neighborhood walkability. Walk Score® was used to assess neighborhood walkability. Overall, 46% of participants were obese and 31% were overweight. The median age of respondents was 34 years, and the majority were female (88%) and married (59%). Participants who resided in a census tract with a higher relative income inequality (high, OR 2.54, 90% CI 1.154–5.601; moderate-high OR 2.527, 90% CI 1.324–4.821) and those who were unmarried (OR 1.807, 90% CI 1.119–2.917) were more likely to be obese versus normal weight. Overweight individuals that resided in areas that were walkable versus car-dependent averaged more days engaging in walking for at least 30-min (p <.05). Identifying individual and neighborhood factors associated with obesity can inform more targeted approaches to combat obesity at multiple ecological levels. The importance of understanding how neighborhood characteristics influence health-related and behavioral outcomes is further reinforced with the current findings. Identifying effective strategies to engage communities and organizations in creating, implementing, adopting, evaluating, and sustaining policy and/or environmental interventions will be needed to combat the obesity epidemic.

Keywords

Health and place Hispanic Minority Low income Physical activity Income inequality 

Notes

Compliance with Ethical Standards

Conflict of interest

None of the authors have any competing interests in the manuscript

Ethical Approval

Ethical Approval was granted by the Texas A&M University Institutional Review Board (IRB Number: IRB2011-0012D).

Informed consent

Informed consent was obtained from all participants. Participation in this study was voluntary and the study was carried out in accordance with all ethical standards.

Funding

This material is based on work that is supported by the National Institute of Food and Agriculture, U.S. Department of Agriculture, under award number 2011-68001-30138. Any opinions, findings, conclusions, or recommendations expressed in this presentation are those of the author(s) and do not necessarily reflect the view of the U.S. Department of Agriculture.

References

  1. 1.
    Committee, P.A.G.A. Physical activity guidelines advisory committee report, 2008. Washington: US Department of Health and Human Services; 2008. pp. A1–14.Google Scholar
  2. 2.
    National Center for Health Statistics (US). Health, United States, 2014: with special feature on adults aged 55–64, Hyattsville, MD: National Center for Health Statistics (US); 2015.Google Scholar
  3. 3.
    Kearns RA. Place and health: towards a reformed medical geography. Profess Geograph. 1993;45(2):p. 139–47.CrossRefGoogle Scholar
  4. 4.
    Sallis JF, et al. Neighborhood built environment and income: examining multiple health outcomes. Soc Sci Med. 2009;68(7):1285–93.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Towne SD Jr, et al. Using walk score and neighborhood perceptions to assess walking among middle-aged and older adults. J Commun Health. 2016;41:977–88.CrossRefGoogle Scholar
  6. 6.
    Hirsch JA, et al. Walk score® and transit score® and walking in the multi-ethnic study of atherosclerosis. Am J Prev Med. 2013;45(2):p. 158–66.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Score, W., Walk score methodology. http://www. walkscore. com/professional/methodology.php. Last viewed January, 2011. 2012;10:3503.Google Scholar
  8. 8.
    Hosler AS, Gallant MP, Riley-Jacome M, Rajulu DT. Relationship between objectively measured walkability and exercise walking among adults with diabetes. J Environ Public Health. 2014. doi: 10.1155/2014/542123.PubMedPubMedCentralGoogle Scholar
  9. 9.
    Lochner KA, et al. Social capital and neighborhood mortality rates in Chicago. Soc Sci Med. 2003;56(8):1797–805.CrossRefPubMedGoogle Scholar
  10. 10.
    Kawachi I, Kennedy BP. Income inequality and health: pathways and mechanisms. Health Serv Res. 1999;34(1 Pt 2):215.PubMedPubMedCentralGoogle Scholar
  11. 11.
    Robert SA, Reither EN. A multilevel analysis of race, community disadvantage, and body mass index among adults in the US. Soc Sci Med. 2004;59(12):2421–34.CrossRefPubMedGoogle Scholar
  12. 12.
    McLeroy KR, et al. An ecological perspective on health promotion programs. Health Educ Behav. 1988;15(4):351–77.Google Scholar
  13. 13.
    Solar O, Irwin A. A conceptual framework for action on the social determinants of health. World Health Organization. 2007. p. 1–77.Google Scholar
  14. 14.
    Marmot M, et al. Closing the gap in a generation: health equity through action on the social determinants of health. Lancet. 2008;372(9650):p. 1661–9.CrossRefPubMedGoogle Scholar
  15. 15.
    Towne S. Differential effects of the great recession on minority populations. 2013.Google Scholar
  16. 16.
    Li Y, et al. Peer effects on childhood obesity from an intervention program. Health Behav Pol Rev. 2016;3(4):323–35.CrossRefGoogle Scholar
  17. 17.
    U.S. Department of Education. Improving Basic Programs Operated by Local Educational Agencies (Title I, Part A). Available at: http://www2.ed.gov/programs/titleiparta/index.html. 2015; Available from: http://tea.texas.gov/About_TEA/News_and_Multimedia/Press_Releases/2015/TEA_identifies_more_than_400_Title_I_Reward_Schools/.
  18. 18.
    Hollar D, et al. Effect of a two-year obesity prevention intervention on percentile changes in body mass index and academic performance in low-income elementary school children. Am J Public Health. 2010;100(4):p. 646–53.CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    CDC. About adult BMI. Available at: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/. [cited 2016].
  20. 20.
    Van Cauwenberg J, et al. Environmental factors influencing older adults’ walking for transportation: a study using walk-along interviews. Int J Behav Nutr Phys Act. 2012;9(1):85.CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Fan JX, Wen M, Kowaleski-Jones L. Tract-and county-level income inequality and individual risk of obesity in the United States. Soc Sci Res. 2016;55:75–82.CrossRefPubMedGoogle Scholar
  22. 22.
    World Bank, Development Research Group. GINI index (World Bank estimate). 2015.Google Scholar
  23. 23.
    Noss A. Household income: 2013. Washington: US Census Bureau, Economics and Statistics Administration, US Department of Commerce, 2014.Google Scholar
  24. 24.
    Carr LJ, Dunsiger SI, Marcus BH. Validation of walk score for estimating access to walkable amenities. Br J Sports Med. 2010;bjsports69609.Google Scholar
  25. 25.
    Sarlio-Lähteenkorva S, Lahelma E. The association of body mass index with social and economic disadvantage in women and men. Int J Epidemiol. 1999;28(3):445–9.CrossRefPubMedGoogle Scholar
  26. 26.
    Institute S, Base SAS 9.4 Procedures guide: statistical procedures. 2014: SAS Institute.Google Scholar
  27. 27.
    Van Dyck D, et al. Neighborhood SES and walkability are related to physical activity behavior in Belgian adults. Prev Med. 2010;50:S74–S79.CrossRefPubMedGoogle Scholar
  28. 28.
    Thorpe Jr, RJ., et al. Race, social and environmental conditions, and health behaviors in men. Fam Commun Health. 2015;38(4):297.CrossRefGoogle Scholar
  29. 29.
    Saelens BE, et al. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health. 2003;93(9):1552–8.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Kim D. et al. Is inequality at the heart of it? Cross-country associations of income inequality with cardiovascular diseases and risk factors. Social Sci Med 2008;66(8):1719–32.CrossRefGoogle Scholar
  31. 31.
    Brown SC, et al. Walk Score®: associations with purposive walking in recent Cuban immigrants. Am J Prev Med. 2013;45(2):202–6.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Prince SA, et al. A comparison of direct versus self-report measures for assessing physical activity in adults: a systematic review. Int J Behav Nutr Phys Act. 2008;5(1):56.CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    BRFSS, Behavioral Risk Factor Surveillance System. Behavioral Risk Factor Surveillance System Questionnaire. 2012. 2013.Google Scholar
  34. 34.
    McLeroy KR, et al. Community-based interventions. Am J Public Health. 2003;93(4):529–33.CrossRefPubMedPubMedCentralGoogle Scholar
  35. 35.
    Medicine, T.R.B.a.I.o., Does the built environment influence physical activity? Examining the evidence. Special Report 282. 2005: Washington.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Samuel D. TowneJr.
    • 1
  • Michael L. Lopez
    • 2
  • Yajuan Li
    • 3
  • Matthew Lee Smith
    • 1
    • 4
  • Judith L. Warren
    • 2
  • Alexandra E. Evans
    • 5
  • Marcia G. Ory
    • 6
  1. 1.Texas A&M School of Public HealthCollege StationUSA
  2. 2.Texas A&M AgriLife ExtensionTexas A&M UniversityCollege StationUSA
  3. 3.Department of Agricultural EconomicsTexas A&M UniversityCollege StationUSA
  4. 4.Department of Health Promotion and Behavior, College of Public HealthThe University of GeorgiaAthensUSA
  5. 5.Michael & Susan Dell Center for Healthy Living Division of Health Promotion and Behavioral Science School of Public HealthUniversity of TexasAustinUSA
  6. 6.Center for Population Health and AgingTexas A&M School of Public HealthCollege StationUSA

Personalised recommendations