Obesity and the built environment at different urban scales: examining the literature.

The majority of people now live in an urban (or suburban) environment. The built (material) environment, its vehicular and pedestrian infrastructure, buildings, and public realm places, are the places used for working, living, and recreating. The environment currently favors and facilitates motorized vehicles generally, and private automobiles especially. The prioritization given to vehicles reduces opportunities for other, more active modes of travel such as walking and bicycling. Though the built environment cannot be said to directly affect human obesity, the built environment clearly has a relationship to obesity as a consequence of physical activity. Most concerning is that rates of obesity have risen as cars have become increasingly privileged, leading to places that favor driving over walking or bicycling. This review examines current empirical literature on the environment and obesity at 3 key urban scales: macro, meso, and micro. Other key issues examined include longitudinal studies and self-selection bias. Evidence for a relationship between urban and suburban environments and obesity is found in the literature, but the lack of longitudinal research and research controlling for self-selection bias remains underrepresented.