Prospective associations of neighborhood healthy food access and walkability with weight status in a regional pediatric health system

• Published in: The international journal of behavioral nutrition and physical activity Vol. 20; no. 1; pp. 1 - 113
• Main Authors: Jiang, Qianxia, Forseth, Bethany, Fitzpatrick, Lauren, Laroche, Helena H, Hampl, Sarah, Davis, Ann M, Steel, Chelsea, Carlson, Jordan
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 20.09.2023; BioMed Central; BMC
• Subjects: Analysis; Body mass index; Body weight; Built environment; Censuses; Childhood obesity; Children; Electronic health records; Ethnicity; Food; Food access; Health aspects; Health care industry; Hispanic Americans; Neighborhoods; Obesity; Obesity in children; Pediatrics; Rural areas; Sociodemographics; Variables; Walkability; Walking; United States > US; Kansas City Missouri
• ISSN: 1479-5868; 1479-5868
• DOI: 10.1186/s12966-023-01514-1

Most neighborhood food and activity related environment research in children has been cross-sectional. A better understanding of prospective associations between these neighborhood environment factors and children's weight status can provide stronger evidence for informing interventions and policy. This study examined associations of baseline and changes in neighborhood healthy food access and walkability with changes in children's weight status over 5 years. Height, weight, and home address were obtained for 4,493 children (> 75% were Black or Latinx) from primary care visits within a large pediatric health system. Eligible participants were those who had measures collected during two time periods (2012-2014 [Time 1] and 2017-2019 [Time 2]). Data were integrated with census tract-level healthy food access and walkability data. Children who moved residences between the time periods were considered 'movers' (N = 1052; 23.4%). Mixed-effects models, accounting for nesting of children within census tracts, were conducted to model associations of baseline and changes in the neighborhood environment variables with Time 2 weight status (BMIz and overweight or obese vs. healthy weight). Models adjusted for weight status and child and neighborhood sociodemographics at baseline. Children living in a neighborhood with [ample] healthy food access at Time 1 had a lower BMIz at Time 2, regardless of mover status. A decrease in healthy food access was not significantly associated with children's weight status at Time 2. Baseline walkability and improvements in walkability were associated with a lower BMIz at Time 2, regardless of mover status.