Body mass index, safety hazards, and neighborhood attractiveness.

BACKGROUND: Neighborhood attractiveness and safety may encourage physical activity and help individuals maintain a healthy weight. However, these neighborhood characteristics may not be equally relevant to health across all settings and population subgroups.
PURPOSE: To evaluate whether potentially attractive neighborhood features are associated with lower BMI, whether safety hazards are associated with higher BMI, and whether environment-environment interactions are present such that associations for a particular characteristic are stronger in an otherwise supportive environment.
METHODS: Survey data and measured height and weight were collected from a convenience sample of 13,102 adult New York City (NYC) residents in 2000-2002; data analyses were completed 2008-2012. Built-environment measures based on municipal GIS data sources were constructed within 1-km network buffers to assess walkable urban form (density, land-use mix, transit access); attractiveness (sidewalk cafés, landmark buildings, street trees, street cleanliness); and safety (homicide rate, pedestrian-auto collision and fatality rate). Generalized linear models with cluster-robust SEs controlled for individual and area-based sociodemographic characteristics.
RESULTS: The presence of sidewalk cafés, density of landmark buildings, and density of street trees were associated with lower BMI, whereas the proportion of streets rated as clean was associated with higher BMI. Interactions were observed for sidewalk cafés with neighborhood poverty, for street-tree density with walkability, and for street cleanliness with safety. Safety hazard indicators were not independently associated with BMI.
CONCLUSIONS: Potentially attractive community and natural features were associated with lower BMI among adults in NYC, and there was some evidence of effect modification.