Relationship between Perceptions about Neighborhood Environment and Prevalent Obesity: Data from the Dallas Heart Study

Although psychosocial stress can result in adverse health outcomes, little is known about how perceptions of neighborhood conditions, a measure of environment-derived stress, may impact obesity. We examined the association between perceptions of neighborhood environment and obesity [defined as body mass index (BMI) ≥ 30 kg/m(2)] among 5907 participants in the Dallas Heart Study, a multi-ethnic, probability-based sample of Dallas County residents. Participants were asked to respond to 18 questions about perceptions of their neighborhood. Using factor analysis, we identified three factors associated with neighborhood perceptions: neighborhood violence, physical environment, and social cohesion. Logistic regression analyses were performed to determine the relationship between each factor (higher quintile = more unfavorable perceptions) and the odds of obesity. Decreasing age, income, and education associated with unfavorable overall neighborhood perceptions and unfavorable perceptions about specific neighborhood factors (p trend <0.05 for all). Increasing BMI was associated with unfavorable perceptions about physical environment (p trend <0.05), but not violence or social cohesion. After adjustment for race, age, sex, income, education, and length of residence, physical environment perception score in the highest quintile remained associated with a 25% greater odds of obesity [OR 1.25,(95% CI 1.03–1.50)]. Predictors of obesity related to environmental perceptions included heavy traffic [OR 1.39,(1.17–1.64)], trash/litter in neighborhood[OR 1.27,(1.01–1.46)], lack of recreational areas[OR 1.21,(1.01–1.46)], and lack of sidewalks[OR 1.25,(95% CI 1.04–1.51)]. Thus, unfavorable perceptions of environmental physical conditions are related to increased obesity. Efforts to improve the physical characteristics of neighborhoods, or the perceptions of those characteristics, may assist in the prevention of obesity in this community.