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- Title
Impact of Changes in the Food, Built, and Socioeconomic Environment on BMI in US Counties, BRFSS 2003-2012.
- Authors
Rummo, Pasquale E.; Feldman, Justin M.; Lopez, Priscilla; Lee, David; Thorpe, Lorna E.; Elbel, Brian
- Abstract
<bold>Objective: </bold>Researchers have linked geographic disparities in obesity to community-level characteristics, yet many prior observational studies have ignored temporality and potential for bias.<bold>Methods: </bold>Repeated cross-sectional data were used from the Behavioral Risk Factor Surveillance System (BRFSS) (2003-2012) to examine the influence of county-level characteristics (active commuting, unemployment, percentage of limited-service restaurants and convenience stores) on BMI. Each exposure was calculated using mean values over the 5-year period prior to BMI measurement; values were standardized; and then variables were decomposed into (1) county means from 2003 to 2012 and (2) county-mean-centered values for each year. Cross-sectional (between-county) and longitudinal (within-county) associations were estimated using a random-effects within-between model, adjusting for individual characteristics, survey method, and year, with nested random intercepts for county-years within counties within states.<bold>Results: </bold>A negative between-county association for active commuting (β = -0.19; 95% CI: -0.23 to -0.16) and positive associations for unemployment (β = 0.17; 95% CI: 0.14 to 0.19) and limited-service restaurants (β = 0.13; 95% CI: 0.11 to 0.14) were observed. An SD increase in active commuting within counties was associated with a 0.51-kg/m2 (95% CI: -0.72 to -0.31) decrease in BMI over time.<bold>Conclusions: </bold>These results suggest that community-level characteristics play an important role in shaping geographic disparities in BMI between and within communities over time.
- Subjects
UNITED States; COUNTIES; CONVENIENCE stores; SCIENTIFIC observation; UNEMPLOYMENT; ECOLOGY; RESTAURANT statistics; FOOD supply statistics; FOOD habits; OBESITY; RESEARCH; CONVENIENCE foods; CROSS-sectional method; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; SOCIOECONOMIC factors; SOCIAL context; RISK assessment; COMPARATIVE studies; RESEARCH funding; QUESTIONNAIRES; BODY mass index
- Publication
Obesity (19307381), 2020, Vol 28, Issue 1, p31
- ISSN
1930-7381
- Publication type
journal article
- DOI
10.1002/oby.22603