Epidemiology: Open Access
Open Access

Abstract

Background: Obesity is become one of the main non-communicable diseases emerging worldwide as a public health problem.
Physical inactivity has been globally recognized as one of the factors leading to obesity, which is the leading causes of long
term chronic diseases that are alarmingly emerging in early age. In the U.S., disadvantaged populations are disproportionally
affected by this phenomenon. Latino children are understudied. Epidemiological researchers have identified the presence of
‘neighborhood’ effect on health as a result of obesogenic environments. Fewer studies have used Level of Fitness as outcomes
for physical inactivity. No prior studies have measured the association between children’s Fitness Score and children’s exposure
to objective characteristic of the urban built environment, and fewer studies evaluated how the relationship with the built
environment varies across different geographic units
Purposes: The present cross-sectional study had two aims. To evaluate the association of 19 variables of 4 components of the
built environment (street connectivity, parks, and restaurants and food store) with children’s Fitness Score. To explore the
variability of the association across different spatial unit of analysis using three not-nested geographies.
Method: The study sample: 159 10-14 year-old Latinos living in the City of Milwaukee, and attending the same school. Fitness
score, socio-demographics, nutrition behavior, and anthropometric measures were geo coded in ArcGIS. Univariate and
multivariate Hierarchical Linear Regression Analysis were run for each geographic unit. Individual behavior and BMI ware
included as confounders in the adjusted models, after controlling for socio-demographics.
Results: Association was overall stronger at the buffer level. Univariate analysis showed scale#2 parks, fast food density, and
dollar store density significantly associated with Fitness score at the buffer level, while at the neighborhood level only Dollar
store remained significant. Street connectivity showed no association with Fitness score across geographies and models.
Female average fitness score across geographies was significantly lower than male, with the gender difference increasing once
controlling for BMI.

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