Table 2.

The associations between unhealthy and healthy food accessibility and obesity prevalence at the ecological level among study participants ages 19 and older in the Netherlands in 2016: results from Spatial Lag of X models.

Variable	Netherlands			Urban			Suburban			Rural
	DEb	IEc	TEd	DEb	IEc	TEd	DEb	IEc	TEd	DEb	IEc	TEd
Food environment
Average distance to next fast food store, km	−0.02	−0.13*	−0.15*	−0.98**	−1.94**	−2.94**	−0.09	−0.56*	−0.65*	−0.04	−0.08	−0.12*
Average distance to next fresh food store, km	−0.07	0.10	0.03	1.17**	2.54**	3.71**	−0.36	0.23	−0.13	−0.08	0.07	−0.01
Average distance to next supermarket, km	−0.02	0.13	0.11	−0.21	0.17	−0.05	−0.27	0.36	0.09	0.02	0.03	0.04
Confounders
Males, %	−0.10**	−0.04	−0.14**	−0.08**	<0.01	−0.08*	−0.05	−0.04	−0.09*	−0.03	−0.08**	−0.12**
People ages 19 to 44, % (ref.)	–	–	–	–	–	–	–	–	–	–	–	–
People ages 45 to 64, %	0.12**	0.14**	0.26**	0.15**	0.07**	0.22**	0.12**	0.05*	0.16**	0.07**	0.13**	0.21**
People ages 65 and older, %	0.06**	0.02	0.07**	0.05**	0.04*	0.09**	0.03**	0.01	0.04**	0.08**	0.01	0.09**
Population densitya, no. of inhabitants/km2	–	–	–	−1.14	−4.82	−5.97**	4.04	−1.08	2.97	43.81**	−27.65	16.17
Non-western immigrants, %	<0.01	−0.03*	−0.03**	−0.02	0.02	<0.01	0.01	−0.03	−0.02	−0.04	−0.09	−0.12**
Social welfare recipients, %	0.22**	0.10*	0.32**	0.43**	0.30**	0.73**	0.24**	−0.08	0.17*	0.14**	0.13*	0.26**
Yearly net income [*1000 Euros]	−0.10**	−0.11**	−0.21**	−0.10**	−0.05**	−0.15**	−0.19**	−0.06**	−0.25**	−0.09**	−0.06*	−0.15**
Low alcohol consumption, %	0.18**	0.02	0.20**	0.24**	−0.05**	0.19**	0.14**	0.02	0.16**	0.12**	0.06**	0.18**
Smokers, %	0.28**	−0.02	0.26**	0.20**	−0.02	0.18**	0.22**	0.09**	0.31**	0.45**	−0.06	0.39**
Regional subtype, ref. Urban
Suburban	0.26*	0.77**	1.03**
Rural	0.36*	−0.10	0.25
R2	0.6796			0.8182			0.6964			0.5983

Abbreviations: No, number; sd, standard deviation; km, kilometre(s).

Footnote: Significant results are denoted with *p < 0.05, **p < 0.01. The models were controlled for sex, age, population density or regional subtype, migration status, unemployment, income, alcohol consumption, and smoking.

^aPoint estimators × 10^–5.

^bDE = direct effect, which is the contribution of the local food environment on the local obesity prevalence (immediate food surrounding).

^cIE = indirect effect, which is the contribution of the food environment in bordering locations on the local obesity prevalence (wider food surrounding).

^dTE = total effect, which is the sum of the direct and indirect effect and the total contribution of the food environment.