Distribution and Determinants of Obesity in New York City, 2003–2007

Abstract

OBJECTIVESThis study characterized the individual and neighborhood‐level determinants and distribution of obesity (BMI≥30 kg/m2) in New York City (NYC) from 2003 to 2007.METHODSIndividual‐level data from the Community Health Survey (n=48,506 adults, 34 neighborhoods) were combined with neighborhood measures. Multilevel regression assessed changes in obesity over time and associations with neighborhood‐level income and food and physical activity amenities, controlling for age, racial/ethnic identity, education, employment, US nativity and marital status, and stratified by gender.RESULTSObesity risk increased by 1.6% (P<0.05) each year, but changes over time differed significantly between neighborhoods and by gender. Obesity risk increased for women, even after controlling for individual and neighborhood‐level factors (Prevalence Ratio (PR)=1.021, P<0.05), whereas no significant changes were reported for men. Neighborhood factors including increased area income (PR=0.932) and availability of local food and fitness amenities (PR=0.890) were significantly associated with reduced obesity (P<0.001).CONCLUSIONSFindings suggest that policies intended to decrease obesity in urban environments should be informed by up to date surveillance data, and may require a variety of initiatives that respond to both the individual and contextual determinants of obesity.