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Clin Pediatr (Phila). 2012 Aug;51(8):750-8. doi: 10.1177/0009922812446010. Epub 2012 May 4.

The built environment and childhood obesity in Durham, North Carolina.

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School of Natural Resources and Environment and Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USA.


The relationship between childhood obesity and aspects of the built environment characterizing neighborhood social context is understudied. This study evaluates the association between 7 built environment domains and childhood obesity in Durham, North Carolina. Measures of housing damage, property disorder, vacancy, nuisances, and territoriality were constructed using data from a 2008 community assessment. Renter-occupied housing and crime measures were developed from public databases. The authors linked these measures to 2008-2009 Duke University Medical Center pediatric preventive care visits. Age- and sex-specific body mass index percentiles were used to classify children as normal weight (>5th and ≤85th percentile), overweight (>85th and ≤95th percentile), or obese (>95th percentile). Ordinal logistic regression models with cluster-corrected standard errors evaluated the association between weight status and the built environment. Adjusting for child-level socioeconomic characteristics, nuisances and crime were associated with childhood overweight/obesity (P < .05). Built environment characteristics appear important to childhood weight status in Durham, North Carolina.

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