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Neighborhood Walkability, Historical Redlining, and Childhood Obesity in Denver, Colorado

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Abstract

Childhood obesity is a precursor to future health complications. In adults, neighborhood walkability is inversely associated with obesity prevalence. Recently, it has been shown that current urban walkability has been influenced by historical discriminatory neighborhood disinvestment. However, the relationship between this systemic racism and obesity has not been extensively studied. The objective of this study was to evaluate the association of neighborhood walkability and redlining, a historical practice of denying home loans to communities of color, with childhood obesity. We evaluated neighborhood walkability and walkable destinations for 250 participants of the Healthy Start cohort, based in the Denver metropolitan region. Eligible participants attended an examination between ages 4 and 8. Walkable destinations and redlining geolocations were determined based on residential addresses, and a weighting system for destination types was developed. Sidewalks and trails in Denver were included in the network analyst tool in ArcMap to calculate the precise walkable environment for each child. We implemented linear regression models to estimate associations between neighborhood characteristics and child body mass index (BMI) z-scores and fat mass percent. There was a significant association between child BMI and redlining (β: 1.36, 95% CI: 0.106, 2.620). We did not find an association between walkability measures and childhood obesity outcomes. We propose that cities such as Denver pursue built environment policies, such as inclusionary zoning and direct investments in neighborhoods that have been historically neglected, to reduce the childhood health impacts of segregated poverty, and suggest further studies on the influences that redlining and urban built environment factors have on childhood obesity.

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Data Availability

Due to IRB and participant confidentiality, human subjects data are not available for distribution. Redlining data are available through the University of Richmond Mapping Inequality project. All other exposure data sources can be found in Supplemental Table 1. Code is available upon request to the first author.

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Acknowledgements

This work was funded by grant 5UG3OD023248 (PI: Dabelea) from the National Institutes of Health and by RD-839278 (PI: Magzamen) from the US Environmental Protection Agency. Ms. Kowalski was supported by a GRA award from the Colorado School of Public Health. We are grateful to Dr. Kirsten Eilertson and the Graybill Statistical Laboratory at Colorado State University, Josh Reyling and the Colorado State University Geospatial Centroid for technical support on this project, and the staff and the participants of the Healthy Start study for their involvement in the study.

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Authors and Affiliations

  1. Department of Environmental and Radiological Health Sciences, Colorado State University, CO, Fort Collins, USA

    Katharina Kowalski, Jeremy Auerbach, Sheena E. Martenies & Sheryl Magzamen

  2. Department of Community Health and Kinesiology, University of Illinois Urbana-Champaign, IL, Champaign, USA

    Sheena E. Martenies

  3. Department of Epidemiology, Colorado School of Public Health, Aurora, CO, USA

    Anne P. Starling, Brianna Moore & Dana Dabelea

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  1. Katharina Kowalski
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Kowalski, K., Auerbach, J., Martenies, S.E. et al. Neighborhood Walkability, Historical Redlining, and Childhood Obesity in Denver, Colorado. J Urban Health 100, 103–117 (2023). https://doi.org/10.1007/s11524-022-00703-w

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