Kathryn M. Neckerman

Neighborhood food environment and walkability predict obesity in New York City.

Background Differences in the neighborhood food environment may contribute to disparities in obesity. Objectives The purpose of this study was to examine the association of neighborhood food environments with body mass index (BMI) and obesity after control for neighborhood walkability. Methods This study employed a cross-sectional, multilevel analysis of BMI and obesity among 13,102 adult residents of New York City. We constructed measures of the food environment and walkability for the neighborhood, defined as a half-mile buffer around the study subject’s home address. Results Density of BMI-healthy food outlets (supermarkets, fruit and vegetable markets, and natural food stores) was inversely associated with BMI. Mean adjusted BMI was similar in the first two quintiles of healthy food density (0 and 1.13 stores/km2, respectively), but declined across the three higher quintiles and was 0.80 units lower [95% confidence interval (CI), 0.27–1.32] in the fifth quintile (10.98 stores/km2) than in the first. The prevalence ratio for obesity comparing the fifth quintile of healthy food density with the lowest two quintiles combined was 0.87 (95% CI, 0.78–0.97). These associations remained after control for two neighborhood walkability measures, population density and land-use mix. The prevalence ratio for obesity for the fourth versus first quartile of population density was 0.84 (95% CI, 0.73–0.96) and for land-use mix was 0.91 (95% CI, 0.86–0.97). Increasing density of food outlets categorized as BMI-unhealthy was not significantly associated with BMI or obesity. Conclusions Access to BMI-healthy food stores is associated with lower BMI and lower prevalence of obesity.

The Urban Built Environment and Obesity in New York City: A Multilevel Analysis:

Purpose. To examine whether urban form is associated with body size within a densely-settled city. Design. Cross-sectional analysis using multilevel modeling to relate body mass index (BMI) to built environment resources. Setting. Census tracts (n = 1989) within the five boroughs of New York City. Subjects. Adult volunteers (n = 13,102) from the five boroughs of New York City recruited between January 2000 and December 2002. Measures. The dependent variable was objectively-measured BMI. Independent variables included land use mix; bus and subway stop density; population density; and intersection density. Covariates included age, gender, race, education, and census tract–level poverty and race/ethnicity. Analysis. Cross-sectional multilevel analyses. Results. Mixed land use (Beta = 2.55, p < .01), density of bus stops (Beta = −.01, p < .01) and subway stops (Beta = −.06, p < .01), and population density (Beta = −.25, p < .001), but not intersection density (Beta = −.002) were significantly inversely associated with BMI after adjustment for individual- and neighborhood-level sociodemographic characteristics. Comparing the 90th to the 10th percentile of each built environment variable, the predicted adjusted difference in BMI with increased mixed land use was −.41 units, with bus stop density was −.33 units, with subway stop density was −.34 units, and with population density was −.86 units. Conclusion. BMI is associated with built environment characteristics in New York City.

Using google street view to audit neighborhood environments

BACKGROUND Research indicates that neighborhood environment characteristics such as physical disorder influence health and health behavior. In-person audit of neighborhood environments is costly and time-consuming. Google Street View may allow auditing of neighborhood environments more easily and at lower cost, but little is known about the feasibility of such data collection. PURPOSE To assess the feasibility of using Google Street View to audit neighborhood environments. METHODS This study compared neighborhood measurements coded in 2008 using Street View with neighborhood audit data collected in 2007. The sample included 37 block faces in high-walkability neighborhoods in New York City. Field audit and Street View data were collected for 143 items associated with seven neighborhood environment constructions: aesthetics, physical disorder, pedestrian safety, motorized traffic and parking, infrastructure for active travel, sidewalk amenities, and social and commercial activity. To measure concordance between field audit and Street View data, percentage agreement was used for categoric measures and Spearman rank-order correlations were used for continuous measures. RESULTS The analyses, conducted in 2009, found high levels of concordance (≥80% agreement or ≥0.60 Spearman rank-order correlation) for 54.3% of the items. Measures of pedestrian safety, motorized traffic and parking, and infrastructure for active travel had relatively high levels of concordance, whereas measures of physical disorder had low levels. Features that are small or that typically exhibit temporal variability had lower levels of concordance. CONCLUSIONS This exploratory study indicates that Google Street View can be used to audit neighborhood environments.

Children living in areas with more street trees have lower prevalence of asthma

Background: The prevalence of childhood asthma in the USA increased by 50% from 1980 to 2000, with especially high prevalence in poor urban communities. Methods: Data on the prevalence of asthma among children aged 4–5 years and on hospitalisations for asthma among children less than 15 years old were available for 42 health service catchment areas within New York City. Street tree counts were provided by the New York City Department of Parks and Recreation. The proximity to pollution sources, sociodemographic characteristics and population density for each area were also measured. Results: Controlling for potential confounders, an increase in tree density of 1 standard deviation (SD, 343 trees/km2) was associated with a lower prevalence of asthma (RR, 0.71 per SD of tree density; 95% CI, 0.64 to 0.79), but not with hospitalisations for asthma (RR, 0.89 per SD of tree density; 95% CI, 0.75 to 1.06). Conclusions: Street trees were associated with a lower prevalence of early childhood asthma. This study does not permit inference that trees are causally related to asthma at the individual level. The PlaNYC sustainability initiative, which includes a commitment to plant one million trees by the year 2017, offers an opportunity for a large prospective evaluation.

Disparities in urban neighborhood conditions: evidence from GIS measures and field observation in New York City.

Although many low-income urban areas are highly walkable by conventional measures such as population density or land use mix, chronic diseases related to lack of physical activity are more common among residents of these areas. Disparities in neighborhood conditions may make poor areas less attractive environments for walking, offsetting the advantages of density and land use mix. This study compared poor and nonpoor neighborhoods in New York City, using geographic information systems measures constructed from public data for US census tracts within New York City (N=2,172) as well as field observation of a matched-pair sample of 76 block faces on commercial streets in poor and nonpoor neighborhoods. Poor census tracts had significantly fewer street trees, landmarked buildings, clean streets, and sidewalk cafes, and higher rates of felony complaints, narcotics arrests, and vehicular crashes. The field observation showed similar results. Improving aesthetic and safety conditions in poor neighborhoods may help reduce disparities in physical activity among urban residents.

Effect of Individual or Neighborhood Disadvantage on the Association Between Neighborhood Walkability and Body Mass Index

OBJECTIVES We sought to test whether the association between walkable environments and lower body mass index (BMI) was stronger within disadvantaged groups that may be particularly sensitive to environmental constraints. METHODS We measured height and weight in a diverse sample of 13 102 adults living throughout New York City from 2000-2002. Each participants home address was geocoded and surrounded by a circular buffer with a 1-km radius. The composition and built environment characteristics of these areas were used to predict BMI through the use of generalized estimating equations. Indicators of individual or area disadvantage included low educational attainment, low household income, Black race, and Hispanic ethnicity. RESULTS Higher population density, more mixed land use, and greater transit access were most consistently associated with a lower BMI among those with more education or higher incomes and among non-Hispanic Whites. Significant interactions were observed for education, income, race, and ethnicity. CONCLUSIONS Contrary to expectations, built environment characteristics were less consistently associated with BMI among disadvantaged groups. This pattern may be explained by other barriers to maintaining a healthy weight encountered by disadvantaged groups.

Disparities in Neighborhood Food Environments: Implications of Measurement Strategies.

abstract Public health researchers have begun to map the neighborhood “food environment” and examine its association with the risk of overweight and obesity. Some argue that “food deserts”—areas with little or no provision of fresh produce and other healthy food—may contribute to disparities in obesity, diabetes, and related health problems. While research on neighborhood food environments has taken advantage of more technically sophisticated ways to assess distance and density, in general, it has not considered how individual or neighborhood conditions might modify physical distance and thereby affect patterns of spatial accessibility. This study carried out a series of sensitivity analyses to illustrate the effects on the measurement of disparities in food environments of adjusting for cross-neighborhood variation in vehicle ownership rates, public transit access, and impediments to pedestrian travel, such as crime and poor traffic safety. The analysis used geographic information systems data for New York City supermarkets, fruit and vegetable markets, and farmers’ markets and employed both kernel density and distance measures. We found that adjusting for vehicle ownership and crime tended to increase measured disparities in access to supermarkets by neighborhood race/ethnicity and income, while adjusting for public transit and traffic safety tended to narrow these disparities. Further, considering fruit and vegetable markets and farmers’ markets, as well as supermarkets, increased the density of healthy food outlets, especially in neighborhoods with high concentrations of Hispanics, Asians, and foreign-born residents and in high-poverty neighborhoods.

Employment and Marriage among Inner-city Fathers

This article uses data from the Urban Poverty and Family Structure Survey of inner-city residents in Chicago to examine the effect of employment on the likelihood that single fathers marry. Our results show that employed fathers are twice as likely as nonemployed fathers to marry the mother of their first child. These results run contrary to Charles Murrays argument that welfare discourages employed, low-income men from marrying. They are consistent with William Julius Wilsons hypothesis that the rise in male joblessness is linked to the rise in never-married parenthood in the inner city. Our analysis also shows that couples are more likely to marry when the woman is a high school graduate. In this population, the enhanced earnings potential of a woman increases, not decreases, the likelihood of marriage. This result is inconsistent with the hypothesis that the closer a womans earnings potential is to a mans, the less likely the couple is to marry. Neither employment nor education fully accounts for the racial and ethnic differences we observe in the marriage rates of fathers in inner-city Chicago.

Place of birth, duration of residence, neighborhood immigrant composition and body mass index in New York City

BackgroundPast research has suggested that changes in culture explain the substantial weight gain seen in many immigrant groups with length of residence in the U.S. and across generations of residence in the U.S. However, it has been theorized that those settling in immigrant and co-ethnic neighborhoods may be buffered against this acculturative process and will be more likely to maintain home country dietary and physical activity patterns. To investigate this theory we incorporated measures of neighborhood immigrant composition into analyses of individuals body mass index (BMI) and generation of immigration and duration of residence in the U.S.MethodsMultilevel analyses were performed using objectively measured height and weight and survey data on diet and physical activity from a sample of 13,011 residents of New York City. Census data were used to calculate the proportion of foreign-born residents and extent of household linguistic isolation in a ½ mile radial buffer around the subjects home.ResultsForeign birth was associated with a significantly lower BMI (-1.09 BMI units, P < 0.001). This association was weakest among Asians (-0.66 BMI units, P = 0.08) and strongest among Black-Caribbeans (-1.41 BMI units, P = 0.07). After controlling for individual level variables, neighborhood proportion foreign-born was not associated with BMI, but increasing neighborhood linguistic isolation was inversely associated with BMI among Hispanics (-2.97 BMI units, P = 0.03). Furthermore among Hispanics, the association between foreign birth and BMI was stronger in low linguistic isolation neighborhoods (-1.36 BMI units, P < 0.0001) as compared to in high linguistic isolation levels (-0.42 BMI units, P = 0.79). Increasing duration of residence in the U.S. was significantly associated with higher BMI overall and among Hispanics.ConclusionThe analyses suggest that acculturation is associated with weight gain, and that neighborhood characteristics are only associated with BMI among Hispanics. However, we suggest that changes in body size currently interpreted as post-migration effects of acculturation to U.S. norms may in fact reflect changes in norms that are taking place internationally.

Reconsidering Access: Park Facilities and Neighborhood Disamenities in New York City

With increasing concern about rising rates of obesity, public health researchers have begun to examine the availability of parks and other spaces for physical activity, particularly in cities, to assess whether access to parks reduces the risk of obesity. Much of the research in this field has shown that proximity to parks may support increased physical activity in urban environments; however, as yet, there has been limited consideration of environmental impediments or disamenities that might influence individuals’ perceptions or usage of public recreation opportunities. Prior research suggests that neighborhood disamenities, for instance crime, pedestrian safety, and noxious land uses, might dissuade people from using parks or recreational facilities and vary by neighborhood composition. Motivated by such research, this study estimates the relationship between neighborhood compositional characteristics and measures of park facilities, controlling for variation in neighborhood disamenities, using geographic information systems (GIS) data for New York City parks and employing both kernel density estimation and distance measures. The central finding is that attention to neighborhood disamenities can appreciably alter the relationship between neighborhood composition and spatial access to parks. Policy efforts to enhance the recreational opportunities in urban areas should expand beyond a focus on availability to consider also the hazards and disincentives that may influence park usage.