Association of the Built Environment and Neighborhood Resources With Obesity-Related Health Behaviors in Older Veterans With Hypertension

Natalie N.Y. Albanese, Iris Lin, Jennifer P. Friedberg, Stuart R. Lipsitz, Andrew Rundle, James W. Quinn, Kathryn M. Neckerman, Andrew Nicholson, John P. Allegrante, Judith Wylie-Rosett, Sundar Natarajan

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To evaluate the association of the built environment and neighborhood resources with exercise, diet, and body mass index (BMI). Method: Person-level data were collected from 533 veterans with uncontrolled hypertension. Neighborhood measures were: (a) census-tract level walkability; and (b) healthy food proximity (HFP). Robust or logistic regression (adjusting for age, race, education, comorbidity, and clustered by provider) was used to evaluate associations between neighborhood and exercise duration (hours/week), exercise adherence (% adherent), saturated fat index (0–10), Healthy Eating Index (HEI; 0–100), HEI adherence (≥74 score), stage of change (SOC) for exercise and diet (% in action/maintenance), BMI (kg/m2), and obesity (BMI ≥ 30 kg/m2). Results: The adjusted difference in HEI score (standard error [SE]) between the highest and lowest walkability tertiles was 3.67 (1.35), p =.006; the corresponding comparison for the saturated fat index was 1.03 (.50), p =.041 and BMI was –1.12 (.45), p =.013. The adjusted odds ratio (OR; 95% confidence intervals [CI]) between the highest and lowest walkability tertiles for HEI adherence was 2.16 [1.22, 3.82], p =.009 and for action/maintenance for exercise SOC was 1.78 [1.15, 2.76], p =.011. The adjusted difference (SE) between the highest and lowest HFP tertiles for exercise duration was.65 (.31), p =.03. The adjusted OR [95% CI] between the highest and lowest HFP tertiles for exercise adherence was 1.74 [1.08, 2.79], p =.023 and for action/maintenance for exercise SOC was 1.75 [1.10, 2.79], p =.034. Conclusions: Geographical location is associated with exercise and diet. Environment-tailored health recommendations could promote healthier lifestyles and decrease obesity-related cardiovascular disease.

Original languageEnglish (US)
JournalHealth Psychology
DOIs
StateAccepted/In press - 2022

Keywords

  • Built environment
  • Diet
  • Exercise
  • Neighborhood walkability
  • Obesity

ASJC Scopus subject areas

  • Applied Psychology
  • Psychiatry and Mental health

Fingerprint

Dive into the research topics of 'Association of the Built Environment and Neighborhood Resources With Obesity-Related Health Behaviors in Older Veterans With Hypertension'. Together they form a unique fingerprint.

Cite this