The Characteristics of Obesogenic Environment and Their Association With BMI Among the Elderly Population in Rural South Korea

Abstract

ObjectivesThe purpose of this research is to analyze the environmental factors affecting obesity in the elderly in rural South Korea. MethodsA survey and Geographical Information System(GIS) data analysis were conducted on 300 elderly people aged 65 and over living in four rural Counties in two Provinces. Formative research was conducted to develop the survey questionnaire. The perception of food environment was measured with five questions, mainly on availability, affordability, and accessibility. The perception of walking environment was measured with eleven questions on esthetics, safety, traffic and community. Social cohesion and the sense of community were asked for measuring social environment. T-test, chi-squared test and stepwise backward regression modeling were performed using Stata/SE 17.0 version. ResultsWe found that the participants from Gangwon-do had higher obesity prevalence than the ones from Jeollanam-do. There was no significant difference in the physical environment between the two Provinces using GIS data analysis; however, there were differences in the perception of the physical environment and the social environment. It was confirmed that the perceptions of the physical environment and social environment were more positive among participants from Jeollanam-do, where obesity prevalence was lower. In stratified stepwise regression models, better perception of food environment was associated with lower BMI in both Provinces. ConclusionsIn this study, various obesity-related environmental factors were explored in rural South Korea. The differences in obesity prevalence in four rural Counties may be explained by different perception on food, walking, and social environments, despite of the similar background factors, such as age distribution, sex ratio, educational level, and financial environment. These findings confirmed that even areas with similar physical settings have different environmental characteristics, which should be considered in developing effective obesity prevention programs. Future research should focus on the development of environmental evaluation tools and the effective measures to enhance the perception of social environment in rural South Korea. Funding SourcesMinistry of Health and Welfare, South Korea NRF of Korea (No. 2021R1A6A1A03044501, No. 2021R1I1A306024811).