Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2009

Open Access 01-12-2009 | Research article

Association between neighborhood safety and overweight status among urban adolescents

Authors: Dustin T Duncan, Renee M Johnson, Beth E Molnar, Deborah Azrael

Published in: BMC Public Health | Issue 1/2009

Login to get access

Abstract

Background

Neighborhood safety may be an important social environmental determinant of overweight. We examined the relationship between perceived neighborhood safety and overweight status, and assessed the validity of reported neighborhood safety among a representative community sample of urban adolescents (who were racially and ethnically diverse).

Methods

Data come from the 2006 Boston Youth Survey, a cross-sectional study in which public high school students in Boston, MA completed a pencil-and-paper survey. The study used a two-stage, stratified sampling design whereby schools and then 9th–12th grade classrooms within schools were selected (the analytic sample included 1,140 students). Students reported their perceptions of neighborhood safety and several associated dimensions. With self-reported height and weight data, we computed body mass index (BMI, kg/m2) for the adolescents based on CDC growth charts. Chi-square statistics and corresponding p-values were computed to compare perceived neighborhood safety by the several associated dimensions. Prevalence ratios (PRs) and 95% confidence intervals (CI) were calculated to examine the association between perceived neighborhood safety and the prevalence of overweight status controlling for relevant covariates and school site.

Results

More than one-third (35.6%) of students said they always felt safe in their neighborhood, 43.9% said they sometimes felt safe, 11.6% rarely felt safe, and 8.9% never felt safe. Those students who reported that they rarely or never feel safe in their neighborhoods were more likely than those who said they always or sometimes feel safe to believe that gang violence was a serious problem in their neighborhood or school (68.0% vs. 44.1%, p < 0.001), and to have seen someone in their neighborhood assaulted with a weapon (other than a firearm) in the past 12 months (17.8% vs. 11.3%, p = 0.025). In the fully adjusted model (including grade and school) stratified by race/ethnicity, we found a statistically significant association between feeling unsafe in one's own neighborhood and overweight status among those in the Other race/ethnicity group [(PR = 1.56, (95% CI: 1.02, 2.40)].

Conclusion

Data suggest that perception of neighborhood safety may be associated with overweight status among urban adolescents in certain racial/ethnic groups. Policies and programs to address neighborhood safety may also be preventive for adolescent overweight.
Literature
1.
Fields AE: Predictors and Consequences of Childhood Obesity. Obesity Epidemiology: Methods and Applications. Edited by: Hu FB. 2008, Oxford, UK: Oxford University Press, 416-436.
2.
McCarthy WJ, Yancey AK, Siegel JM, Wong WK, Ward A, Leslie J, Gonzalez E: Correlation of obesity with elevated blood pressure among racial/ethnic minority children in two Los Angeles middle schools. Prev Chronic Dis. 2008, 5 (2): A46-PubMedPubMedCentral
3.
Daniels SR: The consequences of childhood overweight and obesity. Future Child. 2006, 16 (1): 47-67. 10.1353/foc.2006.0004.CrossRefPubMed
4.
Guerra S, Wright AL, Morgan WJ, Sherrill DL, Holberg CJ, Martinez FD: Persistence of asthma symptoms during adolescence: role of obesity and age at the onset of puberty. Am J Respir Crit Care Med. 2004, 170 (1): 78-85. 10.1164/rccm.200309-1224OC.CrossRefPubMed
5.
Gilliland FD, Berhane K, Islam T, McConnell R, Gauderman WJ, Gilliland SS, Avol E, Peters JM: Obesity and the risk of newly diagnosed asthma in school-age children. Am J Epidemiol. 2003, 158 (5): 406-15. 10.1093/aje/kwg175.CrossRefPubMed
6.
Li L, Law C, Power C: Body mass index throughout the life-course and blood pressure in mid-adult life: a birth cohort study. J Hypertens. 2007, 25 (6): 1215-23. 10.1097/HJH.0b013e3280f3c01a.CrossRefPubMed
7.
Dietz WH: Childhood weight affects adult morbidity and mortality. J Nutr. 1998, 128 (2 Suppl): 411S-414S.PubMed
8.
Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH: Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med. 1992, 327 (19): 1350-5.CrossRefPubMed
9.
Fairfield KM, Willett WC, Rosner BA, Manson JE, Speizer FE, Hankinson SE: Obesity, weight gain, and ovarian cancer. Obstet Gynecol. 2002, 100 (2): 288-96. 10.1016/S0029-7844(02)02053-7.PubMed
10.
Anderson PM, Butcher KE: Childhood obesity: trends and potential causes. Future Child. 2006, 16 (1): 19-45. 10.1353/foc.2006.0001.CrossRefPubMed
11.
Ogden CL, Flegal KM, Carroll MD, Johnson CL: Prevalence and trends in overweight among US children and adolescents, 1999–2000. JAMA. 2002, 288 (14): 1728-32. 10.1001/jama.288.14.1728.CrossRefPubMed
12.
Troiano RP, Flegal KM, Kuczmarski RJ, Campbell SM, Johnson CL: Overweight prevalence and trends for children and adolescents. The National Health and Nutrition Examination Surveys, 1963 to 1991. Arch Pediatr Adolesc Med. 1995, 149 (10): 1085-91.CrossRefPubMed
13.
Bennett GG, Wolin KY, Duncan DT: Social Determinants of Obesity. Obesity Epidemiology: Methods and Applications. Edited by: Hu FB. 2008, Oxford, UK: Oxford University Press, 342-376.
14.
Sallis JF, Glanz K: The role of built environments in physical activity, eating, and obesity in childhood. Future Child. 2006, 16 (1): 89-108. 10.1353/foc.2006.0009.CrossRefPubMed
15.
Carver A, Timperio A, Crawford D: Perceptions of neighborhood safety and physical activity among youth: the CLAN study. J Phys Act Health. 2008, 5 (3): 430-44.PubMed
16.
Grow HM, Saelens BE, Kerr J, Durant NH, Norman GJ, Sallis JF: Where are youth active? Roles of proximity, active transport, and built environment. Med Sci Sports Exerc. 2008, 40 (12): 2071-9. 10.1249/MSS.0b013e3181817baa.CrossRefPubMed
17.
Singh GK, Yu SM, Siahpush M, Kogan MD: High levels of physical inactivity and sedentary behaviors among US immigrant children and adolescents. Arch Pediatr Adolesc Med. 2008, 162 (8): 756-63. 10.1001/archpedi.162.8.756.CrossRefPubMed
18.
Veugelers P, Sithole F, Zhang S, Muhajarine N: Neighborhood characteristics in relation to diet, physical activity and overweight of Canadian children. Int J Pediatr Obes. 2008, 3 (3): 152-9. 10.1080/17477160801970278.CrossRefPubMed
19.
Evenson KR, Scott MM, Cohen DA, Voorhees CC: Girls' perception of neighborhood factors on physical activity, sedentary behavior, and BMI. Obesity. 2007, 15 (2): 430-45. 10.1038/oby.2007.502.CrossRefPubMed
20.
Mota J, Gomes H, Almeida M, Ribeiro JC, Santos MP: Leisure time physical activity, screen time, social background, and environmental variables in adolescents. Pediatr Exerc Sci. 2007, 19 (3): 279-90.PubMed
21.
Evenson KR, Birnbaum AS, Bedimo-Rung AL, Sallis JF, Voorhees CC, Ring K, Elder JP: Girls' perception of physical environmental factors and transportation: reliability and association with physical activity and active transport to school. Int J Behav Nutr Phys Act. 2006, 3: 28-10.1186/1479-5868-3-28.CrossRefPubMedPubMedCentral
22.
Heitzler CD, Martin SL, Duke J, Huhman M: Correlates of physical activity in a national sample of children aged 9–13 years. Prev Med. 2006, 42 (4): 254-60. 10.1016/j.ypmed.2006.01.010.CrossRefPubMed
23.
Li M, Dibley MJ, Sibbritt D, Yan H: Factors associated with adolescents' physical inactivity in Xi'an City, China. Med Sci Sports Exerc. 2006, 38 (12): 2075-85. 10.1249/01.mss.0000233802.54529.87.CrossRefPubMed
24.
Carver A, Salmon J, Campbell K, Baur L, Garnett S, Crawford D: How do perceptions of local neighborhood relate to adolescents' walking and cycling?. Am J Health Promot. 2005, 20 (2): 139-47.CrossRefPubMed
25.
Romero AJ: Low-income neighborhood barriers and resources for adolescents' physical activity. J Adolesc Health. 2005, 36 (3): 253-9. 10.1016/j.jadohealth.2004.02.027.CrossRefPubMed
26.
Gomez JE, Johnson BA, Selva M, Sallis JF: Violent crime and outdoor physical activity among inner-city youth. Prev Med. 2004, 39 (5): 876-81. 10.1016/j.ypmed.2004.03.019.CrossRefPubMed
27.
Molnar BE, Gortmaker SL, Bull FC, Buka SL: Unsafe to play? Neighborhood disorder and lack of safety predict reduced physical activity among urban children and adolescents. Am J Health Promot. 2004, 18 (5): 378-86.CrossRefPubMed
28.
Gordon-Larsen P, McMurray RG, Popkin BM: Determinants of adolescent physical activity and inactivity patterns. Pediatrics. 2000, 105 (6): E83-10.1542/peds.105.6.e83.CrossRefPubMed
29.
Mota J, Delgado N, Almeida M, Ribeiro JC, Santos MP: Physical Activity, Overweight, and Perceptions of Neighborhood Environments Among Portuguese Girls. J Phys Act Health. 2006, 3: 314-322.
30.
Timperio A, Salmon J, Telford A, Crawford D: Perceptions of local neighbourhood environments and their relationship to childhood overweight and obesity. Int J Obes. 2005, 29 (2): 170-5. 10.1038/sj.ijo.0802865.CrossRef
31.
Grafova IB: Overweight children: assessing the contribution of the built environment. Prev Med. 2008, 47 (3): 304-8. 10.1016/j.ypmed.2008.04.012.CrossRefPubMed
32.
Ward DS, Dowda M, Trost SG, Felton GM, Dishman RK, Pate RR: Physical activity correlates in adolescent girls who differ by weight status. Obesity. 2006, 14 (1): 97-105. 10.1038/oby.2006.12.CrossRefPubMed
33.
Krieger N, Chen JT, Ware JH, Kaddour A: Race/ethnicity and breast cancer estrogen receptor status: impact of class, missing data, and modeling assumptions. Cancer Causes Control. 2008, 19 (10): 1305-18. 10.1007/s10552-008-9202-1.CrossRefPubMedPubMedCentral
34.
Behrens T, Taeger D, Wellmann J, Keil U: Different methods to calculate effect estimates in cross-sectional studies. A comparison between prevalence odds ratio and prevalence ratio. Methods Inf Med. 2004, 43 (5): 505-9.PubMed
35.
Thompson ML, Myers JE, Kriebel D: Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done?. Occup Environ Med. 1998, 55 (4): 272-7. 10.1136/oem.55.4.272.CrossRefPubMedPubMedCentral
36.
Axelson O, Fredriksson M, Ekberg K: Use of the prevalence ratio v the prevalence odds ratio as a measure of risk in cross sectional studies. Occup Environ Med. 1994, 51 (8): 574-10.1136/oem.51.8.574.CrossRefPubMedPubMedCentral
37.
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM: Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006, 295 (13): 1549-55. 10.1001/jama.295.13.1549.CrossRefPubMed
38.
Hedley AA, Ogden CL, Johnson CL, Carroll MD, Curtin LR, Flegal KM: Prevalence of overweight and obesity among US children, adolescents, and adults, 1999–2002. JAMA. 2004, 291 (23): 2847-50. 10.1001/jama.291.23.2847.CrossRefPubMed
39.
Kuczmarski RJ, Ogden CL, Guo SS, Grummer-Strawn LM, Flegal KM, Mei Z, Wei R, Curtin LR, Roche AF, Johnson CL: 2000 CDC Growth Charts for the United States: methods and development. Vital Health Stat. 2002, 11 (246): 1-190.
40.
SAS Institute Inc: Statistical Applications Software, Version 9.1.3. Cary, NC. 2008
41.
Zar JH: Biostatistical Analysis, Fourth Edition. 1999, Prentice Hall; New Jersey, 564-
42.
Elliott AC, Reisch JS: Implementing a multiple comparison test for proportions in a 2xC crosstabulation in SAS®. Proceedings of the SAS User's Group International 31, San Francisco, CA, March 26–29. 2006, 10.1093/aje/kwi188. . Paper 204-31
43.
Spiegelman D, Hertzmark E: Easy SAS calculations for risk or prevalence ratios and differences. Am J Epidemiol. 2005, 162 (3): 199-200. 10.1093/ije/27.1.91.CrossRefPubMed
44.
Skov T, Deddens J, Petersen MR, Endahl L: Prevalence proportion ratios: estimation and hypothesis testing. Int J Epidemiol. 1998, 27 (1): 91-5. 10.1037/0002-9432.71.3.298.CrossRefPubMed
45.
Buka SL, Stichick TL, Birdthistle I, Earls FJ: Youth exposure to violence: prevalence, risks, and consequences. Am J Orthopsychiatry. 2001, 71 (3): 298-310. 10.1023/B:CCFP.0000006292.61072.d2.CrossRefPubMed
46.
Stein BD, Jaycox LH, Kataoka S, Rhodes HJ, Vestal KD: Prevalence of child and adolescent exposure to community violence. Clin Child Fam Psychol Rev. 2003, 6 (4): 247-64. 10.1016/1054-139X(96)00129-2.CrossRefPubMed
47.
Bain JE, Brown RT: Adolescents as witnesses to violence. J Adolesc Health. 1996, 19 (2): 83-5. 10.1097/00004583-199303000-00026.CrossRefPubMed
48.
Fitzpatrick KM, Boldizar JP: The prevalence and consequences of exposure to violence among African-American youth. J Am Acad Child Adolesc Psychiatry. 1993, 32 (2): 424-30. 10.1016/1054-139X(93)90008-D.CrossRefPubMed
49.
Schubiner H, Scott R, Tzelepis A: Exposure to violence among inner-city youth. J Adolesc Health. 1993, 14 (3): 214-9. 10.1038/sj.ijo.0803064.CrossRefPubMed
50.
Hu FB: Physical Activity, Sedentary Behaviors, and Obesity. Obesity Epidemiology: Methods and Applications. Edited by: Hu FB. 2008, Oxford, UK: Oxford University Press, 301-319.CrossRef
51.
Must A, Tybor DJ: Physical activity and sedentary behavior: a review of longitudinal studies of weight and adiposity in youth. Int J Obes. 2005, 29 (Suppl 2): S84-96. 10.1038/oby.2007.273.CrossRef
52.
Hu FB: Metabolic and Hormonal Predictors of Obesity. Obesity Epidemiology: Methods and Applications. Edited by: Hu FB. 2008, Oxford, UK: Oxford University Press, 377-398.CrossRef
53.
Roemmich JN, Smith JR, Epstein LH, Lambiase M: Stress reactivity and adiposity of youth. Obesity. 2007, 15 (9): 2303-10. 10.1046/j.1467-789x.2001.00027.x.CrossRefPubMed
54.
Björntorp P: Do stress reactions cause abdominal obesity and comorbidities?. Obes Rev. 2001, 2 (2): 73-86. 10.1210/jc.83.6.1853.CrossRefPubMed
55.
Rosmond R, Dallman MF, Björntorp P: Stress-related cortisol secretion in men: relationships with abdominal obesity and endocrine, metabolic and hemodynamic abnormalities. J Clin Endocrinol Metab. 1998, 83 (6): 1853-9. 10.1207/s15327558ijbm1302_2.PubMed
56.
Kliewer W: Violence exposure and cortisol responses in urban youth. Int J Behav Med. 2006, 13 (2): 109-20. 10.2105/AJPH.2006.092692.CrossRefPubMed
57.
Farley TA, Meriwether RA, Baker ET, Watkins LT, Johnson CC, Webber LS: Safe play spaces to promote physical activity in inner-city children: results from a pilot study of an environmental intervention. Am J Public Health. 2007, 97 (9): 1625-31. 10.1111/j.1468-0262.2007.00733.x.CrossRefPubMedPubMedCentral
58.
59.
60.
Kling JR, Liebman JB, Katz LF: Experimental analysis of neighborhood effects. Econometrica. 2007, 75 (1): 83-119. 10.1111/j.1468-0262.2007.00733.x.CrossRef
61.
Loukaitou-Sideris A, Eck JE: Crime prevention and active living. Am J Health Promot. 2007, 21 (4 Suppl): 380-9. 10.1146/annurev.publhealth.24.100901.140826.CrossRefPubMed
62.
Mair JS, Mair M: Violence prevention and control through environmental modifications. Annu Rev Public Health. 2003, 24: 209-25. 10.1146/annurev.publhealth.24.100901.140826.CrossRefPubMed
63.
Molnar BE, Roberts AL, Browne A, Gardener H, Buka SL: What girls need: recommendations for preventing violence among urban girls in the US. Soc Sci Med. 2005, 60 (10): 2191-204. 10.2105/AJPH.2006.098913.CrossRefPubMed
64.
Molnar BE, Cerda M, Roberts AL, Buka SL: Effects of neighborhood resources on aggressive and delinquent behaviors among urban youths. Am J Public Health. 2008, 98 (6): 1086-93. 10.2105/AJPH.2006.098913.CrossRefPubMedPubMedCentral
65.
Yonas MA, O'Campo P, Burke JG, Gielen AC: Neighborhood-level factors and youth violence: giving voice to the perceptions of prominent neighborhood individuals. Health Educ Behav. 2007, 34 (4): 669-85. 10.1126/science.277.5328.918.CrossRefPubMed
66.
Sampson RJ, Raudenbush SW, Earls F: Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997, 277 (5328): 918-24. 10.1542/peds.106.1.52.CrossRefPubMed
67.
Goodman E, Hinden BR, Khandelwal S: Accuracy of teen and parental reports of obesity and body mass index. Pediatrics. 2000, 106 (1 Pt 1): 52-8. 10.1542/peds.106.1.52.CrossRefPubMed
Metadata
Title
Association between neighborhood safety and overweight status among urban adolescents
Authors
Dustin T Duncan
Renee M Johnson
Beth E Molnar
Deborah Azrael
Publication date
01-12-2009
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2009
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-9-289

Other articles of this Issue 1/2009

BMC Public Health 1/2009 Go to the issue

Research article

Chronic disease prevalence and care among the elderly in urban and rural Beijing, China - a 10/66 Dementia Research Group cross-sectional survey

Research article

Smoking, drinking and body weight after re-employment: does unemployment experience and compensation make a difference?

Study protocol

ACCISS study rationale and design: activating collaborative cancer information service support for cervical cancer screening

Research article

Epidemiology of frequent attenders: a 3-year historic cohort study comparing attendance, morbidity and prescriptions of one-year and persistent frequent attenders

Research article

Comparing three short questionnaires to detect psychosocial dysfunction among primary school children: a randomized method

Study protocol

Community pharmacist intervention in depressed primary care patients (PRODEFAR study): randomized controlled trial protocol