Environment, obesity, and cardiovascular disease risk in low-income women.

BACKGROUND: Financially disadvantaged populations are more likely to live in communities that do not support healthy choices. This paper investigates whether certain characteristics of the built environment are associated with obesity or coronary heart disease (CHD) risk among uninsured low-income women.
METHODS: Using a sample of 2001-2002 data from 2692 women enrolled in the WISEWOMAN program of the Centers for Disease Control and Prevention, the study team performed regression analysis (conducted in January-April 2005) to estimate body mass index (BMI) and the log of 10-year CHD risk as a function of the built environment and socioecologic measures.
RESULTS: For women living in an environment of maximum mixed land use (i.e., an environment more conducive to healthy living), BMI was lower by 2.60 kg/m2 and CHD risk was lower by 20% than for women living in single-use uniform environments (i.e., environments less conducive to healthy living). An additional fitness facility per 1000 residents was associated with BMI and CHD risk that were lower by 1.39 kg/m2 and 15.1%, respectively. Crime was positively associated with BMI and CHD risk, whereas neighborhood affluence was negatively associated. Living in more racially segregated areas was negatively associated with CHD risk among black, Hispanic, and Asian women and positively associated with CHD risk among American Indian women.
CONCLUSIONS: The built environment and socioecologic characteristics of financially disadvantaged women were associated with BMI and CHD risk. More research is needed to understand the effects of racial segregation or acculturation on health for specific subpopulations.