Neighborhood Environments and Disparities in Obesity Rates in New York City

This project will determine whether racial/ethnic and socioeconomic disparities in the prevalence of obesity, sedentary lifestyles and poor diet in New York City are explained by disparities in neighborhood resources that support physical activity (e.g. gyms, parks, pleasant walking environments) and healthy diets (e.g. grocery stores, fruit markets, healthy food restaurants) across neighborhoods in New York. Obesity, sedentary lifestyles, and poor diets are major risk factors for the development of type 2 Diabetes and in New York City these risk factors are far more common among African Americans, Hispanics and those of lower socio-economic status. Prior research in New York City shows that neighborhood characteristics such as urban design features and neighborhood socioeconomic status predict body mass index (BMI). Furthermore, the availability of grocery stores, fruit markets, fast food restaurants, gyms and health clubs, vary by neighborhood in New York City, with minority and poorer neighborhoods having fewer positive resources. The proposed research is a collaboration between Columbia University and the New York City Department of Health and Mental Hygiene (NYCDOHMH). Interview data on demographic characteristics, physical activity, consumption of fruits and vegetables and height and weight (used to calculate BMI) from ~45,000 New Yorkers will be combined with a geographic information system (GIS) based model of the characteristics of New York City neighborhoods. The interview data and zip code of residence were collected as part of five annual citywide random digit dial interviews conducted by NYCDOHMH that occurred from 2002 to 2006, and the sample is representative of the city and its neighborhoods. The GIS model is being built as part of ongoing research on neighborhood effects and is the most comprehensive model of neighborhood resources in New York City built to date. The NYCDOHMH will contribute additional data on restaurant locations from the food service licensing database, locations of pedestrian injuries from automobiles, and neighborhood social capital from their neighborhood surveys. Neighborhoods will be defined using zip codes, and prior research has shown that variation in built and social environment variables at this level are strongly predictive of BMI. Multilevel models will be used to determine the extent to which neighborhood characteristics account for racial/ethnic and socioeconomic disparities in BMI, physical activity and consumption of fruits and vegetables across zip codes in New York City. In addition to analyzing the effects of race/ethnicity and socio-economic status the analyses will control for age, gender and U.S. or foreign born status, and the socio-demographic characteristics of the zip code of residence. This research will contribute to NIDDK's goal of understanding the underlying causes of disparities in the distribution of known risk factors for type 2 diabetes. Furthermore, the analyses will be used to guide New York City's ongoing long term planning process for using urban design to promote public health.