Neighborhood Environment and Adiposity among Older Adults: the Cardiovascular Health of Seniors and the Built Environment study

Background.  Individual neighborhood factors are associated with obesity-related health behaviors and rates; however, there remains a paucity of information characterizing whole environments in these relationships and limited information on the effect for older adults.Methods.  Adults, aged 60 or older living in New York City, were enrolled into the Cardiovascular Health of Seniors and the Built Environment between January 2009 and June 2011.  Walking audits of all streets within 300-meter buffer zones around residential addresses were conducted resulting in the assessment of 34 different neighborhood features hypothesized to be associated with obesity through physical activity and diet.  Outcomes included objective measures of body fat mass (FM), waist circumference (WC), and body mass index (BMI). Stratified linear regression models were used to calculate geographic differences in associations between neighborhood resources and adiposity by gender and age categories in areas where Black, White and Latino residents lived. Results. For women 60-69 years of age living in black areas, neighborhood features resulted in a higher FM than the average Brooklyn neighborhood (Difference (D) =2.15, 95% CI [1.15, 3.15]).  Conversely, for women of the same age living in white and Latino areas, a lower prevalence of FM was observed: white areas: (D= -2.01, 95% CI [-3.62, -0.40]); Latino areas: (D= -1.43, 95% CI [-2.72, -0.14]).  The direction of the effects remained similar for other age groups, although the estimates were less precise.  Estimates of FM were inconsistent across age groups for men living in each of the areas.  Other measurements of adiposity showed similar results.Conclusions.  The composition of neighborhood features in white and Latino residential areas is protective of adiposity, whereas features located in black areas appear to place residents at greater risk.