The Metropolitan Environment and Health: The Impact of Income Inequality, Racial Segregation and Urban Sprawl on the Risk of Physical Inactivity



Physical inactivity is a risk factor for obesity, cardiovascular disease and premature mortality. But despite health warnings, many Americans remain inactive.




The data source was the 2001 Behavioral Risk Factor Surveillance System, a telephone survey of US adults.  Respondents living in all metropolitan areas defined in 2000 were included.  This study used multilevel analysis combining metropolitan level factors:  income inequality (GINI Index), Black-White residential segregation (Dissimilarity Index), urban sprawl (the Urban Affairs Review Sprawl Index) and per capita income along with individual level factors:  sex, age, income, race/ethnicity and education.  The risk of being physically inactive was compared to meeting current CDC guidelines for physical activity.




The final sample consisted of 121,894 adults in 315 metropolitan areas.  In the full multivariate analysis, increased levels of income inequality (odds ratio: 1.052, 95% CI = 1.033, 1.072), segregation (1.008, 95% CI = 1.005, 1.012) and urban sprawl (1.006, 95% CI = 1.003, 1008) were associated with an increased risk of physical activity.




Addressing the physical activity, and its health consequences, may require attention to the structural characteristics of the metropolitan environment.  While recent research highlights the role of the built environment as affecting inactivity, this study suggests that the social environment is also an important predictor of inactivity.

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