Neighborhood built and social environment characteristics: a multilevel analysis of associations with obesity among children and their parents

OBJECTIVE: To examine associations between characteristics of neighborhood built and social environments and likelihood of obesity among family triads living at the same residential address and to explore whether these associations differ between family members. METHODS: Data were from the baseline wave of QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), an ongoing study on the natural history of obesity in 630 Quebec youth aged 8-10 years with a parental history of obesity. Weight and height were measured in children and both biological parents and body mass index was computed. Residential neighborhood environments were characterized using a Geographic Information System and in-person neighborhood audits. Principal components analysis allowed for identification of overarching neighborhood indicators including poverty, prestige, level of urbanicity, traffic, physical disorder and deterioration, and pedestrian friendliness. Multilevel logistic regressions were used to examine associations between neighborhood indicators and obesity within multiple family members residing at the same address while controlling for household-level sociodemographic variables. RESULTS: A total of 417 families were included in the analysis. Families residing in lower and average prestige neighborhoods were more likely to be obese (odds ratio (OR) = 1.69, 95% confidence interval (CI): 1.16, 2.44, and OR = 1.51, 95% CI: 1.09, 2.11, respectively) than those residing in higher prestige neighborhoods. Residing in lower traffic neighborhoods was associated with less obesity (OR = 0.69, 95% CI: 0.50, 0.95). Other neighborhood indicators may have differential effects across family members. For example, as neighborhood poverty increased, obesity was more likely among children but less likely among fathers and no different for mothers. CONCLUSION: Findings indicate that some shared neighborhood exposures are associated with greater risk of obesity for entire families whereas other exposures may heighten obesity risk in some but not all family members. Patterns may reflect differences in the way in which family members use residential neighborhood environments.