Examining the Role of Income Inequality and Neighborhood Walkability on Obesity and Physical Activity among Low-Income Hispanic Adults.

Abstract

Obesity is a major public health issue affecting rising medical costs and contributing to morbidity and premature mortality. We aimed to identify factors that may play a role in obesity and physical activity at the individual and environmental/neighborhood levels. We analyzed data from an adult sample who were parents of students enrolled in a school-based health and wellness program. The sample was restricted to those who were Hispanic and whose children were on free/reduced lunch (n = 377). Dependent variables: body mass index (BMI); neighborhood walkability. Walk Score® was used to assess neighborhood walkability. Overall, 46% of participants were obese and 31% were overweight. The median age of respondents was 34years, and the majority were female (88%) and married (59%). Participants who resided in a census tract with a higher relative income inequality (high, OR 2.54, 90% CI 1.154-5.601; moderate-high OR 2.527, 90% CI 1.324-4.821) and those who were unmarried (OR 1.807, 90% CI 1.119-2.917) were more likely to be obese versus normal weight. Overweight individuals that resided in areas that were walkable versus car-dependent averaged more days engaging in walking for at least 30-min (p <.05). Identifying individual and neighborhood factors associated with obesity can inform more targeted approaches to combat obesity at multiple ecological levels. The importance of understanding how neighborhood characteristics influence health-related and behavioral outcomes is further reinforced with the current findings. Identifying effective strategies to engage communities and organizations in creating, implementing, adopting, evaluating, and sustaining policy and/or environmental interventions will be needed to combat the obesity epidemic.