Mixed land use and obesity: an empirical comparison of alternative land use measures and geographic scales.

Obesity is a growing epidemic in the United States. Walkable neighborhoods, characterized as having the 3Ds of walkability (population Density, land use Diversity, and pedestrian-friendly Design), have been identified as a potentially promising factor to prevent obesity for their residents. Past studies examining the relationship between obesity and walkability vary in geographic scales of neighborhood definitions and methods of measuring the 3Ds. To better understand potential influences of these sometimes arbitrary choices, we test how four types of alternative measures of land use diversity measured at three geographic scales relate to body mass index for 4960 Salt Lake County adults. Generalized estimation equation models demonstrate that optimal diversity measures differed by gender and geographic scale and that integrating walkability measures at different scales improved the overall performance of models.