, Volume 35, Issue 2, pp 179–199 | Cite as

Explaining obesity with urban form: a cautionary tale

  • Tudor D. Bodea
  • Laurie A. Garrow
  • Michael D. Meyer
  • Catherine L. Ross


In recent years, there has been a dramatic increase in studies exploring associations between the built environment and obesity. Many studies have found that built environment characteristics, such as high-density land developments, mixed-land uses, and connected street networks, are associated with lower rates of obesity. However, depending on the research field and the researcher, how one specifies the experimental model and how sociodemographic characteristics of the population are defined and included in the model has led to different policy conclusions and implications. This is not a surprising observation; however, it is one that does seem to have been lost in current discussions. This article highlights several data-processing, model-specification, and model-estimation factors that should be comprehensively considered in studies of the built environment and obesity. Empirical results based on data from Atlanta, GA, USA, illustrate that the association between the built environment and obesity is sensitive to how age, income, and educational attainment are included in the model. Also, a detailed examination of land-use-mix measures shows that it is difficult to create this measure and that results are sensitive to the treatment of missing values. Models that distinguish between overweight and obese individuals are shown to provide richer insights into the associations among obesity, built environment, and sociodemographic characteristics for the Atlanta area. The article concludes by offering modeling recommendations for future studies.


Land use Obesity Specification bias Urban form 



The authors are grateful to Jason Barringer and Ying Zhu who assisted in creating built-environment and travel-time variables and to Marco Castillo who provided helpful suggestions and guidance for testing for the presence of bias in parameter estimates. In addition, the authors are grateful for the helpful comments and suggestions of reviewers.


  1. Bagley, M.N., Mokhtarian, P.L.: The impact of residential neighborhood type on travel behavior: a structural equations modeling approach. Ann. Reg. Sci. 36(2), 279–297 (2002)CrossRefGoogle Scholar
  2. Ball, K., Bauman, A., Leslie, E., Owen, N.: Perceived environmental aesthetics and convenience and company are associated with walking for exercise among Australian adults. Prev. Med. 33, 434–440 (2001)CrossRefGoogle Scholar
  3. Bodea, T.D., Garrow, L.A., Meyer, M.D., Ross, C.E.: The influence of socio-demographic and built environment characteristics on the likelihoods of being overweight and obese: a cautionary tale. The Georgia Institute of Technology (Working Paper) (2006)Google Scholar
  4. Booth, M., Owen, N., Bauman, A., Clavisi, O., Leslie, E.: Social-cognitive and perceived environment influences associated with physical activity in older Australians. Prev. Med. 31, 15–22 (2000)CrossRefGoogle Scholar
  5. Booth, K.M., Pinkston, M.M., Poston, W.S.C.: Obesity and the built environment. J. Am. Diet. Assoc. 105(5, Supplement 1), 110–117 (2005)CrossRefGoogle Scholar
  6. Brownson, R.C., Housemann, R.A., Brown, D.R., Jackson-Thompson, J., King, A.C., Malone, B.R., Sallis, J.F.: Promoting physical activity in rural communities: walking trail access, use, and effects. Am. J. Prev. Med. 18(3), 235–241 (2000)CrossRefGoogle Scholar
  7. Crossman, A., Sullivan, D.A., Benin, M.: The family environment and American adolescents’ risk of obesity as young adults. Soc. Sci. & Med. 63, 2255–2267 (2006)CrossRefGoogle Scholar
  8. De Bourdeaudhiuj, I., Sallis, J.F., Saelens, B.E.: Environmental correlates of physical activity in a sample of Belgian adults. Am. J. Health Promot. 18(1), 83–91 (2003)Google Scholar
  9. Frank, L., Andresen, M.A., Schmid, T.L.: Obesity relationships with community design, physical activity, and time spent in cars. Am. J. Prev. Med. 27(2), 87–96 (2004)CrossRefGoogle Scholar
  10. Frank, L., Sallis, J.F., Conway, T.L., Chapman, J.E., Saelens, B.E., Bachman, W.: Many pathways from land use to health. J. Am. Plann. Assoc. 72(1), 75–87 (2006)CrossRefGoogle Scholar
  11. Giles-Corti, B., Donovan, R.J.: The relative influence of individual, social and physical environment determinants of physical activity. Soc. Sci. & Med. 54(12), 1793–1812 (2002a)CrossRefGoogle Scholar
  12. GilesCorti, B., Donovan, R.J.: Socioeconomic status differences in recreational physical activity levels and real and perceived access to a supportive physical environment. Prev. Med. 35(6), 601–611 (2002b)CrossRefGoogle Scholar
  13. Graham, C., Felton, A.: Variance in obesity across cohorts and countries: a norms-based explanation using happiness surveys. The Brookings Institution, CSED Working Paper No. 42 (2005)Google Scholar
  14. Greene, W.H.: Econometric Analysis, 5th ed. Pearson Education, Inc., Upper Saddle River, New Jersey (2003)Google Scholar
  15. Handy, S.: Critical assessment of the literature on the relationships among transportation, land use, and physical activity. Department of Environmental Science and Policy, University of California, Davis. Prepared for the Transportation Research Board and the Institute of Medicine, Committee on Physical Activity, Health, Transportation and Land Use, July (2004)Google Scholar
  16. Handy, S., Clifton, K.J.: Local shopping as a strategy for reducing automobile travel. Transportation 28(4), 317–346 (2001)CrossRefGoogle Scholar
  17. Handy, S., Xinyu, C., Mokhtarian, P.L.: Self-selection in the relationship between the built environment and walking. J. Am. Plann. Assoc. 72(1), 55–74 (2006)CrossRefGoogle Scholar
  18. Heath, G., Brownson, R.C., Kruger, J., Miles, R., Powell, K.E., Ramsey, L.T., and Task Force on Community Preventive Services: The effectiveness of urban design and land use and transport policies and practices to increase physical activity: a systematic review. J. Phys. Act. Health. 3(Supplement 1), 55–76 (2006)Google Scholar
  19. Hinde, S., Dixon, J.: Changing the obesogenic environment: insights from a cultural economy of car reliance. Transp. Res. Part D: Transp. Environ. 10(1), 31–53 (2005)CrossRefGoogle Scholar
  20. King, A.C., Castro, C., Wilcox, S., Eyler, A.A., Sallis, J.F., Brownson, R.C.: Personal and environmental factors associated with physical inactivity among different racial-ethnic groups of US middle-aged and older-aged women. Health Psychol. 19(4), 354–364 (2000)CrossRefGoogle Scholar
  21. Koppelman, F., Bhat, C.: A self instructing course in mode choice modeling: multinomial and nested logit models, prepared for U.S. Department of Tranportation, Federal Transit Administration (2006)Google Scholar
  22. Krizek, K.J.: Residential relocation and changes in urban travel. J. Am. Plann. Assoc. 69(3), 265 (2003)CrossRefGoogle Scholar
  23. Kuczmarski, R.J., Flegal, K.M., Campbell, S.M., Johnson, C.L.: Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960–1991. J. Am. Med. Assoc. 272(3), 205–211 (1994)CrossRefGoogle Scholar
  24. Kuskowska-Wolk, A., Rossner, S.: Body mass distribution of a representative adult population in Sweden. Diabetes Res. Clinic. Pract. 10(Supplement 1), S37–S41 (1990)CrossRefGoogle Scholar
  25. Lamerz, A., Kuepper-Nybelen, J., Wehle, C., Bruning, N., Trost-Brinkhues, G., Brenner, H., Hebebrand, J., Herpertz-Dahlmann, B.: Social class, parental education, and obesity prevalence in a study of six-year-old children in Germany. Int. J. Obes. 29(4), 373–380 (2005)CrossRefGoogle Scholar
  26. Little, R., Rubin, D.: Statistical Analysis with Missing Data, 2nd ed. John Wiley & Sons, Inc., Hoboken, New Jersey (2002)Google Scholar
  27. Lobstein, T., Baur, L., Uauy, R.: Obesity in children and young people: a crisis in public health. Obes. Rev. 5(S1), 4–85 (2004)CrossRefGoogle Scholar
  28. Lopez-Zetina, J., Lee, H., Friis, R.: The link between obesity and the built environment. Evidence from an ecological analysis of obesity and vehicle miles of travel in California. Health & Place 12(4), 656–664 (2006)Google Scholar
  29. Loureiro, M.L., Nayga, R.M.J.: Obesity, weight loss, and physician’s advice. Soc. Sci. & Med. 62, 2458–2468 (2006)CrossRefGoogle Scholar
  30. Manski, C.: Identification problems in the social sciences. Harvard University Press, Cambridge, (1995)Google Scholar
  31. McCullagh, P.: Regression models for ordinal data. J. Roy. Stat. Soc. B 42(2), 109–142 (1980)Google Scholar
  32. McKelvey, R.D., Zavoina, W.: A statistical model for the analysis of ordinal level dependent variables. J. Math. Soc. 4, 103–120 (1975)CrossRefGoogle Scholar
  33. Metro Council: Street connectivity: an evaluation of case studies in the Portland region. Retrieved December 2005 from (2004)
  34. Mokhtarian, P., Cao, X.: Examining the impacts of residential self-selection on travel behavior: a focus on methodologies. The University of California, Davis (Working Paper) (2006)Google Scholar
  35. NuStats: 2001 Atlanta household travel survey: final report. Prepared for Atlanta Regional Commission, Atlanta, GA (2003)Google Scholar
  36. Parks, S.E., Housemann, R.A., Brownson, R.C.: Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States. J. Epidemiol. Commun. Health 57(1), 29–35 (2003)CrossRefGoogle Scholar
  37. Pendola, R., Gen, S: BMI, auto use, and the urban environment in San Francisco. Health & Place (in press, corrected proof)Google Scholar
  38. Rao, P., Miller, R.L.: Applied econometrics. Wadsworth Publishing Company, Belmont (1971)Google Scholar
  39. Robert Wood Johnson Foundation: The built environment and physical activity: what is the relationship? The Synthesis Project (Research Synthesis Report No. 11) (2007)Google Scholar
  40. Romon, M., Duhamel, A., Collinet, N., Weill, J.: Influence of social class on time trends in BMI distribution in 5-year-old French children from 1989 to 1999. Int. J. Obes. 29(1), 54–59 (2005)CrossRefGoogle Scholar
  41. Ross, C.E.: Walking, exercising, and smoking: does neighborhood matter? Soc. Sci. & Med. 51(2), 265–274 (2000)CrossRefGoogle Scholar
  42. Shannon, T., Giles-Corti, B., Pikora, T., Bulsara, M., Shilton, T., Bull, F.: Active commuting in a university setting: assessing commuting habits and potential for modal change. Transp. Policy 13(3), 240–253 (2006)CrossRefGoogle Scholar
  43. Stahl, T., Rutten, A., Nutbeam, D., Bauman, A., Kannas, L., Abel, T., Luschen, G., Rodriquez, D.J.A., Vinck, J., van der Zee, J.: The importance of the social environment for physically active lifestyle—results from an international study. Soc. Sci. & Med. 52(1), 1–10 (2001)CrossRefGoogle Scholar
  44. StataCorp: Stata Statistical Software: Release 9. StataCorp LP, College Station (2006)Google Scholar
  45. Strauss, R.S., Pollack, H.A.: Epidemic increase in childhood overweight, 1986–1998. J. Am. Med. Assoc. 286(22), 2845–2848 (2001)CrossRefGoogle Scholar
  46. Stein, R.: Car Use drives up weight, study finds. The Washington Post, May 31, 2004. Retrieved on-line at–2004May30.html (2004)
  47. Szklo, M., Nieto, F.J.: Epidemiology: Beyond the Basics. Aspen Publishers (1999)Google Scholar
  48. The Endocrine Society: A Handbook on Obesity in America. Retrieved November 2005, from (2004)
  49. Transportation Research Board and Institute of Medicine: Does the Built Environment Influence Physical Activity? Examining the Evidence (No. TRB Special Report 282). Transportation Research Board, Washington, DC (2005)Google Scholar
  50. Troped, P.J., Saunders, R.P., Pate, R.R., Reininger, B., Ureda, J.R., Thompson, S.J.: Associations between self-reported and objective physical environmental factors and use of a community rail-trail. Prev. Med. 32(2), 191–200 (2001)CrossRefGoogle Scholar
  51. UK Institution of Civil Engineers: Does urban sprawl make people fat? Retrieved on-line at (2007)
  52. US Department of Health and Human Services: Physical Activity and Health: A Report of the Surgeon General. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA (2006)Google Scholar
  53. United States Environmental Protection Agency: Travel and Environmental Implications of School Sitting (No. EPA 231-R-03-004). Washington, DC (2003)Google Scholar
  54. Wilcox, S., Castro, C., King, A.C., Housemann, R., Brownson, R.C.: Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States. J. Epidemiol. Commun. Health 54(9), 667–672 (2000)CrossRefGoogle Scholar
  55. Williamson, D.F.: Descriptive epidemiology of body weight and weight change in US adults. Ann. Inter. Med. 119(7), 646 (1993)Google Scholar

Copyright information

© Springer Science+Business Media, LLC. 2007

Authors and Affiliations

  • Tudor D. Bodea
    • 1
  • Laurie A. Garrow
    • 1
  • Michael D. Meyer
    • 1
    • 2
  • Catherine L. Ross
    • 3
    • 4
  1. 1.School of Civil and Environmental EngineeringGeorgia Institute of TechnologyAtlantaUSA
  2. 2.Georgia Transportation InstituteGeorgia Institute of TechnologyAtlantaUSA
  3. 3.City and Regional Planning ProgramGeorgia Institute of TechnologyAtlantaUSA
  4. 4.Center for Quality Growth and Regional DevelopmentGeorgia Institute of TechnologyAtlantaUSA

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