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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2012 Nov 1;103(Suppl 3):S15–S21. doi: 10.1007/BF03403830

Linking Childhood Obesity to the Built Environment: A Multi-level Analysis of Home and School Neighbourhood Factors Associated With Body Mass Index

Jason A Gilliland 14,24,34,✉, Claudia Y Rangel 14, Martin A Healy 14, Patricia Tucker 44, Janet E Loebach 14, Paul M Hess 54, Meizi He 64, Jennifer D Irwin 74, Piotr Wilk 34,84
PMCID: PMC6973850  PMID: 23618083

Abstract

Objectives

This study examines environmental factors associated with BMI (body mass index) levels among adolescents with the aim of identifying potential interventions for reducing childhood obesity.

Methods

Students (n=1,048) aged 10–14 years at 28 schools in London, ON, completed a survey providing information on age, sex, height, weight, home address, etc., which was used to construct age-sex adjusted BMI z-scores. The presence of recreation opportunities, fast-food outlets and convenience stores was assessed using four areal units around each participant’s home and school neighbourhood: “circular buffers” encompassing territory within a straight-line distance of 500 m and 1000 m; and “network buffers” of 500 m and 1000 m measured along the street network. School neighbourhoods were also assessed using school-specific “walksheds”. Multilevel structural equation modeling techniques were employed to simultaneously test the effects of school-environment (Level 2) and home-environment (Level 1) predictors on BMI z-scores.

Results

Most participants (71%) had a normal BMI, 16.9% were overweight, 7.6% were obese, and 4.6% were considered underweight. Multilevel analyses indicated that built environment characteristics around children’s homes and schools had a modest but significant effect on their BMI. The presence of public recreation opportunities within a 500 m network distance of home was associated with lower BMI z-scores (p<0.05), and fast-food outlets within the school walkshed was associated with higher BMI z-scores (p<0.05).

Conclusion

Interventions and policies that improve children’s access to publicly provided recreation opportunities near home and that mitigate the concentration of fast-food outlets close to schools may be key to promoting healthy lifestyles and reducing childhood obesity.

Key words: Obesity, child, adolescent, environment, diet, recreation

Mots clés: obésité, enfant, adolescent, environnement, régime alimentaire, loisir

Footnotes

Acknowledgements: This study was supported by research grants from the Heart and Stroke Foundation of Canada, the Green Shield Canada Foundation and the Canadian Institutes of Health Research’s Institutes of Human Development, Child and Youth Health, and Nutrition, Metabolism and Diabetes

Conflict of Interest: None to declare

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