Exploring heterogeneous relationships between multiscale built environment and overweight in urbanizing China

Abstract

Overweight has emerged as a significant threat to people's health. Although a handful of studies have evaluated the neighborhood built environment (BE) and overweight connection, there is little knowledge about how urbanization moderates the connection. The present study seeks to assess whether there are differences in the BE and overweight connection between urban and rural settings, and how the connection varies across different urbanization rates. Based on a nationwide sample of 7883 individuals in China, we consider both scales of BE elements and examine their heterogeneous associations with overweight. The findings show that both scales of BE elements are essential determinants of overweight. Significant differences in the connection between urban and rural settings are observed. Most BE elements are shown to be significant contributors in urban settings, whereas only residential density, metro, and public transit supply play significant roles in rural settings. Additionally, the BE and overweight connection also varies across urbanization rates. The BE elements are more influential to overweight in more urbanized areas. Our findings indicate that planning efforts at both neighborhood and city scales are essential and targeted planning strategies should be made according to local contexts.