Elizabeth Tarlov1,2, Abigail Silva2,3, Coady Wing4, Sandy Slater5, Stephen A Matthews6, Kelly K Jones7, Shannon N Zenk1. 1. College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA. 2. Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, Illinois, USA. 3. Department of Public Health Sciences, Loyola University Chicago, Maywood, Illinois, USA. 4. School of Public and Environmental Affairs, Indiana University, Bloomington, Indiana, USA. 5. School of Pharmacy, Concordia University Wisconsin, Mequon, Wisconsin, USA. 6. Department of Sociology and Criminology, Department of Anthropology, The Pennsylvania State University, University Park, Pennsylvania, USA. 7. National Socio-Environmental Synthesis Center, Annapolis, Maryland, USA.
Abstract
OBJECTIVE: Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas. METHODS: In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014. RESULTS: Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period. CONCLUSIONS: Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population.
OBJECTIVE: Improving neighborhood walkability has been proposed as a policy intervention to reduce obesity. The objective of this study was to evaluate longitudinal relationships between neighborhood walkability and body weight among adults living in large urban areas. METHODS: In this retrospective longitudinal study of United States military veterans using Department of Veterans Affairs health care, Veterans Affairs clinical and administrative data (2007-2014) were linked to environmental measures constructed from public (2006-2014) and proprietary (2008-2014) sources, and linear regression models with person fixed effects were used to estimate associations between walkability and BMI among 758,434 men and 70,319 women aged 20 to 80 years in 2009 to 2014. RESULTS: Neighborhood walkability was associated with small reductions in BMI. Effects were most pronounced among men aged 30 to 49 and 50 to 64. For women, differences were largest in the two youngest age groups, 20 to 29 and 30 to 49, though only estimates for all women combined were statistically significant. For women aged 30 to 49, effect sizes grew when the sample was limited to those who remained in the same neighborhood during the entire follow-up period. CONCLUSIONS: Investments in the built environment to improve walkability may be a useful strategy for weight control in some segments of the adult population.
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