Relationship between urban sprawl and physical activity, obesity, and morbidity

Abstract

Purpose To determine the relationship between urban sprawl, health, and health-related behaviors. Design Cross-sectional analysis using hierarchical modeling to relate characteristics of individuals and places to levels of physical activity, obesity, body mass index (BMI), hypertension, diabetes, and coronary heart disease. Setting U.S. counties (448) and metropolitan areas (83). Subjects Adults (n = 206,992) from pooled 1998, 1999, and 2000 Behavioral Risk Factor Surveillance System (BRFSS). Measures Sprawl indices, derived with principal components analysis from census and other data, served as independent variables. Self-reported behavior and health status from BRFSS served as dependent variables. Results After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked (p =.004), obesity (p