Sandy J. Slater

Availability of Physical Activity–Related Facilities and Neighborhood Demographic and Socioeconomic Characteristics: A National Study

OBJECTIVES We examined associations between neighborhood demographic characteristics and the availability of commercial physical activity-related outlets by zip code across the United States. METHODS Multivariate analyses were conducted to assess the availability of 4 types of outlets: (1) physical fitness facilities, (2) membership sports and recreation clubs, (3) dance facilities, and (4) public golf courses. Commercial outlet data were linked by zip code to US Census Bureau population and socioeconomic data. RESULTS Results showed that commercial physical activity-related facilities were less likely to be present in lower-income neighborhoods and in neighborhoods with higher proportions of African American residents, residents with His-panic ethnicity, and residents of other racial minority backgrounds. In addition, these neighborhoods had fewer such facilities available. CONCLUSIONS Lack of availability of facilities that enable and promote physical activity may, in part, underpin the lower levels of activity observed among populations of low socioeconomic status and minority backgrounds.

Tobacco Industry Marketing at Point of Purchase After the 1998 MSA Billboard Advertising Ban

Point-of-purchase marketing has become increasingly important for the tobacco industry in the United States.1 In the wake of the 1998 master settlement agreement (MSA) that required tobacco advertising on billboards across the country to end on April 24, 1999, the point-of-purchase environment is likely to assume even greater importance in the industrys marketing efforts. One goal of the billboard advertising ban (as well as other MSA advertising and promotion restrictions) was to reduce youth exposure to cigarette advertising. However, previous research suggests that the tobacco industry is able to compensate for an inability to advertise in one medium by transferring advertising dollars to other marketing activities.2–6 Accordingly, there is concern that the MSA billboard advertising ban may merely shift tobacco advertising funding to other efforts, such as point-of-purchase marketing. In this study, we used data from a unique national sample of retailers to explore changes in the point-of-purchase environment after implementation of the billboard tobacco advertising ban.

The Impact of State Laws and District Policies on Physical Education and Recess Practices in a Nationally Representative Sample of US Public Elementary Schools

OBJECTIVE To examine the impact of state- and school district-level policies on the prevalence of physical education (PE) and recess in a nationally representative sample of US public elementary schools. DESIGN Analyses from annual, nationally representative, cross-sectional surveys of school administrators in the United States. SETTING Data were collected through surveys conducted between February and June during the 2006-2007 through 2008-2009 school years. State laws and district policies were compiled annually by researchers at the University of Illinois at Chicago using established legal research techniques. PARTICIPANTS The sample size was 47 states, 690 districts, and 1761 schools. MAIN EXPOSURES State- and school district-level PE and recess-related laws. MAIN OUTCOME MEASURES Twenty minutes of daily recess and 150 min/wk of PE. RESULTS The odds of schools having 150 min/wk of PE increased if they were located in states (odds ratio [OR], 2.8; 95% CI, 1.3-5.7) or school districts (OR, 2.4; 95% CI, 1.3-4.3) having a law or policy requiring 150 min/wk of PE. Schools located in states with laws encouraging daily recess were significantly more likely to have 20 minutes of recess daily (OR, 1.8; 95% CI, 1.2-2.8). District policies were not significantly associated with school-level recess practices. Adequate PE time was inversely associated with recess and vice versa, suggesting that schools are substituting one form of physical activity for another rather than providing the recommended amount of both recess and PE. CONCLUSION By mandating PE or recess, policy makers can effectively increase school-based physical activity opportunities for youth.

The Association Between Community Physical Activity Settings and Youth Physical Activity, Obesity, and Body Mass Index

BACKGROUND This study examined the association between the level of physical activity (PA) friendliness of the built environment and adolescent PA and body mass index using a national sample of youth and data collected from the communities where they reside. METHODS Data on height, weight, and PA were taken from annual nationally representative cross-sectional Monitoring the Future surveys of 8th and 10th graders in schools, from 2001 through 2003. Measures of safety, outdoor and commercial PA settings, and urban sprawl were constructed using data collected from the communities in which the students reside. Multilevel models were run and controlled for youth and community demographic and socioeconomic characteristics. RESULTS Increased levels of physical disorder were associated with decreased PA and higher weight. A greater number of commercial PA facilities was associated with increased PA. More compact communities were associated with lower weight and less sports participation. CONCLUSIONS It is important to explore these associations to help guide future development patterns and land use policies to create more active neighborhoods.

State variation in retail promotions and advertising for Marlboro cigarettes

BACKGROUND There is some evidence that tobacco companies marketing efforts undermine the effects of comprehensive tobacco control programmes. OBJECTIVE To determine whether point-of-purchase advertising and promotions are more pervasive in states where comprehensive tobacco control programmes are underway. DESIGN Cross sectional survey using 1996 data, with merged records of the existence of local tobacco advertising restrictions. PARTICIPANTS AND SETTING 581 tobacco retail stores located in close proximity to high schools in mainland USA. MAIN OUTCOME MEASURES Existence of gift-with-purchase, number of interior advertisements, and exterior store advertisements for Marlboro cigarettes. RESULTS After controlling for store type and existence of advertising restrictions, offer of a gift-with-purchase for Marlboro cigarettes was significantly more likely in states with comprehensive tobacco control programmes than those without programmes (odds ratio 2.59, 95% confidence interval 1.57 to 4.26). Although not significant, results show an increase in the number of interior and exterior store advertisements for stores located in states with a comprehensive tobacco control programme than those in other states. CONCLUSION Results suggest some point-of-purchase tobacco promotions and advertising are more pervasive in states with comprehensive tobacco control programmes. These efforts are likely to act against the objectives of programmes and need to be accounted for in programme evaluations.

After the Master Settlement Agreement: Trends in the American Tobacco Retail Environment from 1999 to 2002

Research indicates that one impact of the Master Settlement Agreement (MSA) may be to increase the focus of the tobacco industry’s marketing approach on the retail tobacco environment. This article aims to provide an overview of and trends in the post-MSA American tobacco retail environment from 1999 to 2002, nationally, by region, and by locale. We examined the following specific retail tobacco environment issues: price, promotions, advertising, and placement, which stimulate or reduce demand for tobacco products. Data for this article were obtained as part of the Impac Teen Project—A Policy Research Partnership to Reduce Youth Substance Use. Results show overall high levels of advertising, promotional activity, and price increase trends across the United States. Tobacco promotions in stores increased between 2001 and 2002. Stores in the south and rural areas tended to have the lowest prices and highest prevalence of promotions and advertising, suggesting a need for tobacco control intervention.

The impact of state safe routes to school-related laws on active travel to school policies and practices in U.S. elementary schools

This study examined the relationship between state laws requiring minimum bussing distances, hazardous route exemptions, sidewalks, crossing guards, speed zones, and traffic control measures around schools and active travel to school (ATS) policies/practices in nationally representative samples of U.S. public elementary schools between 2007-2009. The state laws and school data were compiled through primary legal research and annual mail-back surveys of principals, respectively. Multivariate logistic and zero-inflated poisson regression indicated that all state law categories (except for sidewalks) relate to ATS. These laws should be considered in addition to formal safe routes to school programs as possible influences on ATS.

Walkable Communities and Adolescent Weight

BACKGROUND Neighborhood design features have been associated with health outcomes, including the prevalence of obesity. PURPOSE This study examined the association between walkability and adolescent weight in a national sample of public secondary school students and the communities in which they live. METHODS Data were collected through student surveys and community observations between February and August 2010, and analyses were conducted in Spring 2012. The sample size was 154 communities and 11,041 students. A community walkability index and measures of the prevalence of adolescent overweight and obesity were constructed. Multivariable analyses from a cross-sectional survey of a nationally representative sample of 8th-, 10th- and 12th-grade public school students in the U.S. were run. RESULTS The odds of students being overweight (AOR 0.98, 95% CI=0.95, 0.99) or obese (AOR=0.97, 95% CI=0.95, 0.99) decreased if they lived in communities with higher walkability index scores. CONCLUSIONS Results suggest that living in more-walkable communities is associated with reduced prevalence of adolescent overweight and obesity.

Validating Adolescent Socioeconomic Status: Comparing School Free or Reduced Price Lunch with Community Measures

The use of free or reduced price lunch (FRL), as a measure of socioeconomic status (SES), has received mixed reviews in the literature. This study expands on the limited research on the validity of FRL as a measure of SES by examining the relationship between FRL and a series of community-based SES measures to determine whether FRL is an adequate proxy for adolescent SES. Data are from a nationally representative sample of 154 public high schools in 2010 from Bridging the Gap with corresponding school level data from the National Center for Education Statistics’ (NCES) Common Core of Data (CCD) to obtain a measure of percent of students receiving FRL and using ArcGIS 9 software with the ACS 05–09, matched at the census block group level to construct measures of community SES. School zone level SES measures obtained include: median household income, percent of families in poverty, percent of families with children younger than 18 years in poverty, and the percent of all households in poverty. Data collected through community observations were used to construct a physical disorder scale. Percent FRL was strongly and significantly associated with the percent of families in poverty (r=0.67), percent of families with children younger than 18 years (r=0.67), percent of households in poverty (r=0.66), median household income (r=−0.60), and physical disorder (r=0.56) in the expected directions. Additionally, all community based measures of socioeconomic status were highly correlated with each other. The validity and limitations of FRL as a proxy for adolescent SES are discussed.

Association between state physical education (PE) requirements and PE participation, physical activity, and body mass index change.

OBJECTIVE To determine if state physical education (PE) laws are associated with student physical education attendance and physical activity (PA), and whether physical education and competitive food laws, in conjunction, are associated with lower BMI change. METHOD State laws regarding physical education time requirements and competitive foods in 2003 and 2006 were classified as strong, weak, or none, based on codified law ratings obtained from the Classification of Laws Associated with School Students. Laws were linked to student data on PE attendance and physical activity (8th grade, Spring 2007) and BMI change (5th-8th grade, 2004-2007), obtained from the Early Childhood Longitudinal Study (n=5510 students in 40 states). RESULTS Girls reported 0.31 more days of activity (95% CI: 0.02, 0.61) and were more likely to attend physical education ≥ 3 days/week (74.1% versus 52.1%, difference=22.0, 95% CI: 2.1, 42.0) if they resided in states with strong physical education laws compared to no physical education laws. Weak physical education laws had modest associations with PE and activity, and there was no evidence that weak laws reduce BMI gain regardless of competitive food laws. CONCLUSION Strong physical education laws with specific time requirements may increase physical education attendance and activity in girls. There is insufficient evidence that physical education laws reduce student weight gain.