Development of a novel Obesogenic Built environment CharacterisTic (OBCT) index for the Netherlands

Abstract

BACKGROUND AND AIM: Despite the potential synergistic nature of obesogenic built environment characteristics, few studies combined factors across the food and physical activity environments. This study aims to compose a comprehensive, theory-based, expert-informed index to quantify built environment characteristics relevant for adult overweight and obesity for all administrative neighbourhoods in the Netherlands for 2016. METHODS: The Dutch OBCT-index consists of 16 components related to food environments (density and healthiness of all food outlets) and physical activity environments including exercise availability (density of sports facilities) and transport-related components related to walkability, driveability and bikeability (population density, land use mix, sidewalk density, intersection density, green space, retail- and service destination density, destination accessibility, public transport density, distance to train station, job density, distance to nearest highway ramp, bicycle pathway density and parking pressure). For each neighbourhood, data were collected from public and commercial sources and processed in GIS such that each component was scaled to range between 0-100. The resulting OBCT-index was calculated as an average of componental scores across the food and physical activity environments, where higher scores corresponded to more obesogenic neighbourhoods. RESULTS:The OBCT score was composed for all 12821 administrative neighbourhoods in the Netherlands and ranged from 37.38-86.80 (mean=47.83, SD=3.37). The province of North Holland stood out with Amsterdam having both extremes of obesogenicity. Across urbanization degrees, the most rural neighbourhoods (500 addresses/km2) scored 4.35 units (95%CI:4.16-4.55, p0.01) higher than the most urban (2500 addresses/km2). Similarly, neighbourhoods in the highest quartile of housing prices (mean=€358800, SD=€115431) scored 4.02 units (95%CI:3.54-4.50, p0.01) higher than the lowest quartile (mean=€95420, SD=€12264). CONCLUSIONS:The OBCT-index is a potentially useful tool to quantify obesgenicity of neighbourhoods and warrants further research applications. KEYWORDS: obesogenic environment, built environment, food environment, physical activity environment