Youth Weight Status and Perceptions of Neighborhood Safety Prompt Community-Level Engagement

Abstract

Due to the confounding influence of factors which have given rise to the pervasiveness of childhood obesity, spatial epidemiology is becoming a prevalent methodological option for exploring the influence of non-biological factors on unhealthy weight gain in youth. Through the exploration of contributors to obesity across a known geographic area, researchers can better understand the community-level impact of those factors on youth health status. PURPOSE:To explore the relationship between perceptions of neighborhood-level safety and youth health status in a target school zone. METHODS:Objective measures of height and weight were gathered from 112 elementary students (age = 9.8±1.85; 54 female). Home addresses and familial perceptions of safety while engaged in neighborhood-level physical activities were gathered using a previously-validated questionnaire. Safety factors included perceived police presence in areas supporting physical activity and perceived safety for daytime or nighttime physical activities. Hot spot analysis using the Getis-Ord Gi* algorithm was used to identify spatial clusters of high and low BMI and safety zones. OLS regression was used explore associations in high and low spatial clustering between student BMI and familial perceptions of safety. RESULTS:55% of students displayed an unhealthy weight profile (BMI-for-age >85th percentile). Overall, spatial clusters of BMI hot spots were significantly associated with spatial clusters of perceptions of safety (F(4,106)=30.18, p<0.01; R2 = 0.53. Significant negative associations were observed for perceived police presence in areas supporting physical activity (p<0.01) and perceived safety for daytime physical activities (p <0.01); no association was observed for perceived safety for nighttime physical activities (p = 0.43). CONCLUSIONS:Unhealthy weight status in youth was significantly associated with perceptions of safety for engaging in neighborhood-level physical activities. By coupling hot spot analysis with OLS, overlapping spatial patterns of high need for perceived safety and BMI could be examined at the residential level. This approach has the potential to inform decision making among community partners regarding resource allocation to enhance youth health status in neighborhoods displaying utmost need.