Elsevier

Health & Place

Volume 15, Issue 3, September 2009, Pages 897-902
Health & Place

Regional differences in walking frequency and BMI: What role does the built environment play for Blacks and Whites?

https://doi.org/10.1016/j.healthplace.2009.02.010Get rights and content

Abstract

Studies have found that urban sprawl explains many regional differences in BMI and walking behavior. Yet, African Americans, who often live in dense, urban neighborhoods with exemplar street connectivity, suffer disproportionately from obesity. This study analyzed walking and BMI among 1124 Whites and 691 Blacks in Los Angeles County and southern Louisiana in relation to neighborhood safety, street connectivity, and walking destinations. While the built environment partly explains regional differences in walking and BMI among Whites, the magnitude of effect was modest. There were no regional differences in outcomes for African Americans; individual rather than neighborhood characteristics served as the best predictors.

Introduction

Because neighborhood design has been associated with physical activity, it may explain why obesity rates vary significantly by state and region over time (Mokdad et al., 1999, Mokdad et al., 2001, Mokdad et al., 2003; Galuska et al., 2006). One study found that states with the highest rates of urban sprawl also suffered the steepest increases in obesity (Vandegrift and Yoked, 2004). Many argue that urban sprawl is unhealthy because it discourages an active lifestyle which includes walking, bicycling, and other forms of exercise. Poor street connectivity and large blocks in sprawling neighborhoods increase trip distances; modern suburban development practices routinely segregate land uses, separating residents from walking destinations like stores and places to exercise like parks (Plantinga and Bernell, 2007). Studies of both metropolitan areas (Lopez, 2004; Ewing et al., 2003) and individuals (Frank et al., 2004) have identified a link between urban sprawl and obesity.

Paradoxically, African Americans, who have higher obesity rates than non-Hispanic whites, often live in urban neighborhoods that are, in terms of their density, high street connectivity, and many walking destinations, models of healthy design (Lopez and Hynes, 2006). Yet these same neighborhoods also tend to have worse access to parks (Gordon-Larsen et al., 2006; Godbey and Graefe, 1992; Wolch et al., 2005), higher concentrations of poverty (Sampson and Wilson, 1995; Wilson, 1987), and higher rates of violent crime (Shihadeh and Flynn, 1996), factors that may counteract the benefits of good design.

Even when African Americans live in affluent neighborhoods, numerous studies have shown that they benefit less than similarly placed Whites from the opportunities in those neighborhoods for maintaining healthy lifestyle behaviors such as walking (Acevedo-Garcia et al., 2008). The influence of neighborhood characteristics on individuals may be modified by race and ethnicity (Krieger, 2000; Williams, 2005).

This study looked at randomly sampled non-Hispanic whites and African Americans in Los Angeles and southern Louisiana to determine to what extent differences in neighborhood characteristics explain regional differences in walking and BMI by race.

Section snippets

Methods

Data for these analyses come from a study of neighborhoods, marketing and individual health behaviors conducted in Los Angeles County and pre-Katrina Southern Louisiana in 2004–2005. Our sampling approach was multi-staged from densely populated (>2000 residents per square mile) urban census tracts in Los Angeles county within 17 miles of Drew Medical Center (1328 tracts) and in Louisiana counties within a 2 h drive of New Orleans (381 tracts). Out of those census tracts, a random sample of 114

Analyses

In order to make the sample more representative of the sampling frame, we constructed post-stratification weights. The weights were calculated separately for Louisiana and Los Angeles and are based on the tract counts of people stratified by (1) gender, (2) age (<34, 35–44, 45–54, 55–65), (3) race/ethnicity (non-Hispanic white, non-Hispanic black, Hispanic, and other), and (4) median tract household income (<$27,000, $27–40,000, $40–55,000, >55,000). Because of the large variance in weights

Regional differences in built environment

Regional differences in non-Hispanic whites’ neighborhood were substantial (Table 1). Respondents in Los Angeles had better access to parks (p<0.0001) and lived less than a mile away from more than twice as many markets as respondents in Southern Louisiana (p<0.0001). Their neighborhoods also differed structurally. The street-networks in Louisiana tracts were significantly better connected than in Los Angeles (alpha=0.25 versus 0.23, p<0.0001) and median block length was shorter. Neighborhood

Discussion

The theory that good urban design (i.e. better access to parks and shopping destinations, shorter block lengths, etc.) leads to improved health behaviors and outcomes best applies to whites, who lived in neighborhoods with significantly higher SES (p<0.0001) than African Americans’ neighborhoods. While more parks were associated with lower BMI, they were not related to walking behaviors in contrast to other studies (Wen et al., 2007). However, it is possible that we are just unable to detect an

Conclusions

While the built environment partly explains regional differences in walking and BMI among whites, the magnitude of effect is quite modest. Un-modifiable individual characteristics factors like age and gender play a large role in walking behavior and BMI. This is particularly true for African Americans, whose walking behaviors and BMI were the same in both sites despite pronounced differences in the built environment. Alternative paradigms for conceptualizing and creating environmental

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