Abstract
Considerable research has been conducted to advance our understanding of how environmental factors influence people’s health behaviors (e.g., leisure-time physical inactivity) at the neighborhood level. However, different environmental factors may operate differently at different geographic locations. This study explores the inconsistent findings regarding the associations between environmental exposures and physical inactivity. To address spatial autocorrelation and explore the impact of spatial non-stationarity on research results which may lead to biased estimators, this study uses spatial regression models to examine the associations between leisure-time physical inactivity and different social and physical environmental factors for all counties in the conterminous U.S. By comparing the results with the conventional ordinary least squares regression and spatial lag model, the geographically weighted regression model adequately addresses the problem of spatial autocorrelation (Moran’s I of the residual = 0.0293) and highlights the spatial non-stationarity of the associations. The existence of spatial non-stationarity that leads to biased estimators, which were often ignored in past research, may be another reason for the inconsistent findings in previous studies besides the modifiable areal unit problem and the uncertain geographic context problem. Also, the observed associations between environmental variables and leisure-time physical inactivity are helpful for developing location-based policies and interventions to encourage people to undertake more physical activity.
Highlights
Researchers in public health and preventive medicine have examined the effects of environmental exposures on various health problems
This study examined the effects of various contextual factors on leisure-time physical inactivity (LTPI) at the county level in the contiguous U.S The associations between these factors and LTPI were investigated using a non-spatial regression model (OSL) and two spatial regression models (SLM and geographically weighted regression (GWR))
By comparing the results of these three models, we found the existence of spatial autocorrelation and non-stationarity, which could lead to biased estimators but were mostly ignored in previous studies
Summary
Researchers in public health and preventive medicine have examined the effects of environmental exposures on various health problems. There is growing evidence that indicates the association between environmental exposures and health outcomes [1,2,3,4]. Many researchers are interested in physical inactivity [6,7,8] and its influence on chronic diseases, such as type-II diabetes, obesity, and cardiovascular diseases [9,10,11,12,13]. Previous studies have found that both LTPI and NLTPI are affected by environmental contexts [15,16,17,18,19,20,21,22]
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