Perceptions of the environment, physical activity, and obesity.

Obesity rates are rising rapidly across the developed and developing world. Until recently obesity research has mainly focused on biological, psychological and behavioural factors. But there is growing agreement that environmental factors play an important role as well. In this study data from the 2003 Health Survey for England (n = 14,836) were analysed from a multilevel perspective to examine (1) the associations of the perceptions of the local environment with obesity, self-rated health, and physical activity, and (2) whether physical activity mediates the association between the perceptions of the environment, and obesity and self-rated health. This study found that perceptions of the friendliness of the local environment were mainly associated with self-rated health; perceived access to leisure facilities with sports activities; perceived access to a post office with walking; and the presence of social nuisances with obesity and poor self-rated health. In addition, positive perceptions of the social environment (i.e., social support and social capital) were associated with higher levels of physical activity, and lower levels of poor self-rated health and obesity. Only limited support was found for the idea that health behaviours mediate the associations between the perceptions of the environment, obesity, and self-rated health. Controlling for the three physical activity measures only rendered a small number of associations with self-rated health non-significant, and did not affect the associations with obesity. Overall, the results show that certain aspects of the environment may contribute to the risk of obesity and poor health. More research is needed to examine the specific mechanisms that link (the perceptions of) the environment to obesity and health.