Assessing Obesity Risk: The Interaction of the Built and Food Environments with African Americans in Chicago.

backgroundThe built environment and food environment have been well documented as correlated factors of obesity, but literature has paid less attention to how these environments interact with racial and ethnic composition to affect obesity. This study examines the racial-ethnic context of obesity concerning the built environment and food environment in a racially segregated city, Chicago.

methodsThe obesity data was sourced from the Healthy Chicago Survey, which gathered information through landline and cell phone interviews with adults aged 18 years or older. The built environment was measured by density, diversity, and design: the density was measured in 1000 residents per square mile within a community; the design of the built environment was measured by the intersection density; and the diversity was measured by the entropy index for land use mix. Spatial statistics were used to identify local clusters and outliers of built environments. We used the North American Industry Classification System codes to distinguish different types of food stores. We used ordinary least squares regression models to examine the effects of the built environment on the obesity rate and included interaction terms to investigate how the built environment interacts with racial composition to impact the obesity rate.

resultsOur results show that population density had a positive association with obesity rates when the African American population percentage increased. Both intersection density and the land use mix were negatively associated with obesity rates. However, as the percentage of the African American population increased, the magnitude of the negative association between the intersection density and obesity rate decreased, while the magnitude of the negative association between the land use entropy index and obesity rate increased. Besides, built environments are more important than food environments in reducing the obesity rate, although grocery stores showed negative effects on obesity while restaurant establishments showed positive effects on obesity.

conclusionsWe provide suggestive evidence that improving urban planning and design to increase the intersection density and land use diversity might significantly reduce the obesity rate, although race was significant in the obesity rate, and the magnitudes of effects of intersection density and land use diversity on the obesity rate differed in African American communities. This evidence highlights the importance of considering demographic factors in designing and planning urban environments to promote public health. Race significantly influenced the obesity rate, with varying effects observed in African American communities. Our findings suggest that tailored urban planning strategies might be necessary to effectively address obesity in different populations.