The Built Environment and Obesity: What We Know and What We Need to Know

OBECTIVES:

 

  1. Summarize current research and evaluate state of knowledge on the built environment/obesity link.

 

2.         Outline gaps in current knowledge and suggest additional needed research.

 

 

ABSTRACT

 

A number of studies have been published exploring the relationship between the built environment and obesity.  The vast majority of these studies have been suburban and cross sectional, comparing current outcomes to current conditions.  A very limited number have studied obesity before and after an environmental amenity has been built and none have been longitudinal with obesity as an outcome.  Few have focused on inner city and minority populations.  This is an appropriate time to assess the current state of the evidence.

 

While the some of the literature suggests that there may be a relationship between the built environment and obesity, there are a number of important research needs including:

 

Statistical/Epidemiological issues:  Are multilevel studies appropriate models for studying built environment/obesity relationships?  Does the evidence meet conventional standards of causality?

 

Longitudinal studies.  Do people move to automobile focused neighborhoods because they are already overweigh? Or does weight rise after moving to sprawled communities?

 

Interventions.  A limited number of neighborhoods might benefit from the installation of sidewalks or other pedestrian amenities.  But many other communities might not be so easily retrofitted.  What can be done to address obesity in the vast majority of already built neighborhoods?

Special Populations.  Most studies to date have focused on predominately suburban neighborhoods.  What can be done to improve the built environment in inner cities and communities of color? How does this research apply to people with disabilities?

 

Addressing these issues are critical if the current obesity epidemic is to be reduced.

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