Abstract
BackgroundVarious aspects of the environment are correlated with obesity. Most of the previous work in this area centers on the built environment. We sought to better understand the association of the natural environment with obesity.MethodsWe used the Natural Amenities Scale to characterize the attractiveness of 2,545 US counties based on access to open water, varied topography, and mild climate. We obtained the height, weight, age, sex, and address of adults from three different sources. The Departments of Motor Vehicles from seven US states provided over 38 million records. A web survey contributed 3,012 from 48 states and the District of Columbia. A clinical study of adults with diabetes from four states provided 974 more for a total of 38,159,046 analyzable records. We used logistic regression to model the association of obesity with natural amenities while controlling for age, sex, year of data collection, and various socioeconomic characteristics of the county.ResultsNatural amenities were inversely associated with obesity in all three populations. Over 20% of residents of low amenity areas were obese, but less than 10% of those living with the best natural amenities were obese.ConclusionsThe natural environment may affect health. Residing in areas with access to open water and a variety of topographic features as well as cool, dry summers and warm, sunny winters is associated with lower rates of obesity.
Highlights
The environment is associated with health issues
We used logistic regression to model the association of obesity with natural amenities while controlling for age, sex, year of data collection, and various socioeconomic characteristics of the county
Natural amenities were inversely associated with obesity in all three populations
Summary
The environment is associated with health issues. For instance, obesity tends to be more common in the southern United States than New England or the Pacific Northwest [1]. Et al used weather station records to estimate climate amenable for physical activity at the county level and linked them to telephone survey data from 2002. They reported lower body mass indices (BMI) among those counties with the most amenable climate after controlling for individual risk factors, road density, household income, and unemployment [4]. McGinn, et al showed an association between physical activity and perceived measures of the natural environment, but not to objective measures [3]. We sought to better understand the association of the natural environment with obesity
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