Abstract

Citation

Ewing R, Schmid T, Killingsworth R, Zlot A, Raudenbush S. Relationship between urban sprawl and physical activity, obesity, and morbidity. Am J Health Promot 2003 Sep-Oct;18(1):47-57.

Abstract

PURPOSE: To determine the relationship between urban sprawl, health, and health-related behaviors. DESIGN: Cross-sectional analysis using hierarchical modeling to relate characteristics of individuals and places to levels of physical activity, obesity, body mass index (BMI), hypertension, diabetes, and coronary heart disease. SETTING: U.S. counties (448) and metropolitan areas (83). SUBJECTS: Adults (n = 206,992) from pooled 1998, 1999, and 2000 Behavioral Risk Factor Surveillance System (BRFSS). MEASURES: Sprawl indices, derived with principal components analysis from census and other data, served as independent variables. Self-reported behavior and health status from BRFSS served as dependent variables. RESULTS: After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked (p = .004), obesity (p < .001), BMI (p = .005), and hypertension (p = .018). Residents of sprawling counties were likely to walk less during leisure time, weigh more, and have greater prevalence of hypertension than residents of compact counties. At the metropolitan level, sprawl was similarly associated with minutes walked (p = .04) but not with the other variables. CONCLUSION: This ecologic study reveals that urban form could be significantly associated with some forms of physical activity and some health outcomes. More research is needed to refine measures of urban form, improve measures of physical activity, and control for other individual and environmental influences on physical activity, obesity, and related health outcomes.

Full Text

The full text is available at https://dx.doi.org/10.4278/0890-1171-18.1.47

At A Glance

Physical Activity Environment Variables

# Type of Environment/Location
448Total Environments/Locations
448Community/Neighborhood as a Whole
# Scale
83Metro
448County
Measure objective perceived
Street Connectivity ✔ ✘
Land Use ✔ ✘
Population/Housing Density ✔ ✘
Degree of centering - extent to which development is focused on region's core; composite index ✔ ✘

Domain(s)

Physical Activity Environment

Measure Type

GIS protocol/detailed description

Measure Availability

Not available

Number of Items

Not applicable

Study location

Metro/Urban

USA

83 metropolitan areas and 448 metropolitan counties across the USA

Languages

Not applicable

Information about Development of Measure

Nothing to add

Study Design

Study Participants

Age

Adults

Sex

Female

Male

Race/Ethnicity

Hispanic

White

Black/African American

Multiethnic/racial population (no further detail)

Predominantly Low-income/Low-SES

Not reported

Sample Size

382601

Study Design

Design Type

Correlational/Observational

Health Outcomes Assessed

Obesity

Physical activity/inactivity

Obesity Measures

BMI or percent above BMI cut-offs

BMI Measured or Self-reported

Self-reported height

Self-reported weight

Covariates

Sociodemographic characteristics (socioeconomic status, race)

Data Reported on Race/Ethnicity

Qualitative description

Data Reported on SES

Not applicable

SES-related Variables

Not applicable

How To Use

Administration

Who Administered

Existing data (e.g., GIS, licensing)

How Administered

Not applicable

Time Required

Not applicable

Training Required

Not applicable

Instructions on Use

Not reported

Data Analysis

Data Collection/Analysis Costs

Not available

Data Collection/Protocol

Not available

Instructions on Data Analysis

Not applicable

Validity (0)

There are no validity tests reported for this measure.

Reliability (0)

There are no reliability tests reported for this measure.