Citation:

Gray, C., L. Messer, K. Rappazzo, J. Jagai, S. Grabich, AND D. Lobdell. The association between physical inactivity and obesity is modified by five domains of environmental quality in U.S. adults: A cross-sectional study. PLOS ONE . Public Library of Science, San Francisco, CA, 13(8):e0203301, (2018). https://doi.org/10.1371/journal.pone.0203301

Impact/Purpose:

This study addresses research questions under Sustainable and Healthy Communities (Project 2.64 Indicators, Indices & Report on the Environment and Project 2.62 Community Public Health & Well-Being). The National Health Environmental Effects Research Laboratory in the Environmental Public Health Division, Epidemiology Branch is currently engaged in research aimed at developing a measure that estimates overall environmental quality at the county level across the U.S. spanning the years 2000 – 2005 called the Environmental Quality Index (EQI). This work is being conducted for the purpose of learning more about how various environmental factors contribute in concert to health disparities in low-income, underrepresented minority and vulnerable populations, and to better estimate the total environmental and social context to which humans are exposed

Description:

Physical inactivity is a primary contributor to the obesity epidemic, but may be promoted or hindered by environmental factors. To examine how cumulative environmental quality may modify the inactivity-obesity relationship, we linked county-level Behavioral Risk Factor Surveillance System (BRFSS) data with the Environmental Quality Index (EQI), a composite measure of five environmental domains (air, water, land, built, and sociodemographic) across all U.S. counties. We estimated the county-level association (N=3,137 counties) between 2009 age-adjusted leisure-time physical inactivity (LTPIA) and 2010 age-adjusted obesity from BRFSS across EQI tertiles using multi-level linear regression, with a random intercept for state, adjusted for percent minority and rural-urban status. We modelled overall and sex-specific estimates, reporting prevalence differences (PD) and 95% confidence intervals. In the overall population results, the PD increased from the best (PD=0.341 [0.287, 0.396]) to worst (PD=0.645 [0.599, 0.690]) tertile of environmental quality. We observed similar trends in males from best (PD=0.244 [0.194, 0.294]) to worst (PD=0.601 [0.556, 0.647]) quality environments, and in females from best (PD=0.446 [0.385, 0.507]) to worst (PD=0.655 [0.607, 0.703]). We found that poor environmental quality exacerbates the LTPIA-obesity relationship. Research and programs aimed at improving obesity through LTPIA may benefit from considering this relationship.

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