Does Compact Built Environment Help to Reduce Obesity? Influence of Population Density on Waist–Hip Ratio in Chinese Cities
Abstract
:1. Introduction
2. Materials and Methods
2.1. Data Source
2.2. Outcome Variable: Waist–Hip Ratio
2.3. Built Environment Elements
2.4. Confounding Variables: Respondents’ Characteristics
2.5. Mediators: Respondents’ Behaviours and Health Status
2.6. Data Process
2.7. Statistical Models
3. Results
3.1. The Association between Built Environment and WHR
3.2. The Mediators between Built Environment and WHR
4. Discussion
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Variable | Definition | Obs. | Mean (SD)/Obs (%) | Min | Max |
---|---|---|---|---|---|
built environment | |||||
Population density (Cont.) | A continuous variable indicating the neighborhood population density, which is population size divided by neighborhood area (unit: 10,000 persons/km2) | 5479 | 0.82 (2.25) | 0 | 16.83 |
Population density | A categorical variable indicating the neighborhood population density (unit: 10,000 persons/km2). (0,0.1] = 1; (0.1,0.5] = 2; (0.5,1] = 3 (reference); (1,1.5] = 4;(1.5,2] = 5; (2,2.5] = 6; more than 2.5 = 7 | 5479 | 1 | 7 | |
0~0.1 | 2251 (41.08%) | 0 | 1 | ||
0.1~0.5 | 1722 (31.43%) | 0 | 1 | ||
0.5~1 | 610 (11.13%) | 0 | 1 | ||
1~1.5 | 340 (6.21%) | 0 | 1 | ||
1.5~2 | 106 (1.93%) | 0 | 1 | ||
2~2.5 | 133 (2.43%) | 0 | 1 | ||
>2.5 | 317 (5.76%) | 0 | 1 | ||
Food environment | |||||
Grocery density | The number of fruit/vegetable stores and vendors in the neighborhood divided by neighborhood area (unit: number/km2) | 5479 | 12.68 (51.60) | 0 | 700 |
Restaurant types | The number of restaurant types in the neighborhood, including fast-food restaurants, other indoor restaurants, outdoor fixed food stalls, and ice cream parlors | 5479 | 2.01 (1.14) | 0 | 4 |
Physical activity environment | |||||
Presence of parks | A dummy variable indicating whether parks are in the neighborhood | 5479 | 1450 (26.46%) | 0 | 1 |
Presence of bus stops | A dummy variable indicating whether bus stops are in the neighborhood | 5479 | 4033 (73.61%) | 0 | 1 |
Company density | The number of private enterprises in the neighborhood divided by neighborhood area (unit: number/km2) | 5479 | 10.60 (61.90) | 0 | 803.57 |
Presence of schools | A dummy variable indicating whether schools are in the neighborhood | 5479 | 3711 (67.73%) | 0 | 1 |
Socio-economic attributes | |||||
Male | A dummy variable indicating whether the respondent is male | 5479 | 2632 (48.04%) | 0 | 1 |
Age | The respondent’s age | 5479 | 47.98 (12.06) | 18 | 72 |
Han nationality | A dummy variable indicating whether the respondent is Han nationality | 5479 | 4992 (91%) | 0 | 1 |
Education | The year of respondent’s education | 5479 | 8.71 (4.04) | 0 | 18 |
Employment | A dummy variable indicating whether the respondent has a job | 5479 | 2896 (52.86%) | 0 | 1 |
Married | A dummy variable indicating whether the respondent is married | 5479 | 4800 (87.61%) | 0 | 1 |
Household size | The number of family members living together | 5479 | 3.52 (1.36) | 1 | 10 |
Household income | The logarithm of household annual gross income (unit: 10,000 yuan) | 5479 | 10.11 (1.38) | 0 | 13.97 |
Attitudes | |||||
Healthy diet | A dummy variable indicating the importance of eating a healthy diet is very important or the most important | 5479 | 1899 (34.66%) | 0 | 1 |
Physically active | A dummy variable indicating whether the importance of being physically active is very important or the most important | 5479 | 1666 (30.41%) | 0 | 1 |
Mediators | |||||
Smoker | A dummy variable indicating whether the respondent smokes | 5472 | 1809 (33.06%) | 0 | 1 |
Drinker | A dummy variable indicating whether the respondent drinks | 5477 | 2138 (39.04%) | 0 | 1 |
Car ownership | A dummy variable indicating whether the respondent owns one or more cars | 5474 | 508 (9.28%) | 0 | 1 |
Sleep duration | Respondent’s sleeping duration per day (unit: hour) | 5417 | 7.83 (1.17) | 4 | 14 |
Physical activity duration | Respondent’s physical activity duration per week (unit: hour) | 5479 | 0.95 (3.08) | 0 | 17.5 |
Sedentary duration | Respondent’s sedentary duration per week (unit: hour) | 5479 | 21.90 (14.89) | 0 | 85 |
Sick | A dummy variable indicating whether the respondent is sick | 5466 | 813 (14.87%) | 0 | 1 |
Continuous Population Density | Categorical Population Density | Women | Men | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Non−Obese WHR (WHR < 0.8 a) | Obese (WHR ≥ 0.8 a) | Non−Obese WHR (WHR < 0.9) | Obese (WHR ≥ 0.9) | |||||||||
Beta | CI | Beta | CI | Beta | CI | Beta | CI | Beta | CI | Beta | CI | |
Population density (Cont.) | 0.031 | [−0.001,0.003] | ||||||||||
Population density | ||||||||||||
0~0.1 | 0.077 * | [0.001, 0.021] | 0.048 | [−0.010, 0.015] | 0.112 | [−0.000, 0.027] | 0.074 | [−0.006, 0.019] | 0.162 | [−0.005, 0.035] | ||
0.1~0.5 | 0.019 | [−0.005, 0.011] | 0.078 | [−0.003, 0.013] | 0.010 | [−0.007, 0.009] | 0.081 * | [0.000, 0.014] | −0.012 | [−0.013, 0.011] | ||
0.5~1 (ref.) | ||||||||||||
1~1.5 | −0.056 | [−0.035, 0.001] | −0.026 | [−0.019, 0.011] | −0.122 *** | [−0.047, −0.009] | 0.045 | [−0.005, 0.022] | −0.024 | [−0.028, 0.020] | ||
1.5~2 | −0.042 ** | [−0.035, −0.009] | 0.139 | [−0.006, 0.061] | −0.050 ** | [−0.039, −0.006] | 0.016 | [−0.008, 0.019] | −0.036 | [−0.031, 0.010] | ||
2~2.5 | −0.033 ** | [−0.026, −0.006] | 0.174 ** | [0.009, 0.041] | 0.000 | [−0.017, 0.018] | −0.061 *** | [−0.027, −0.009] | −0.037 | [−0.032, 0.008] | ||
>2.5 | 0.042 * | [0.001, 0.026] | 0.134 ** | [0.005, 0.025] | 0.076 | [−0.001, 0.038] | 0.141 ** | [0.008, 0.047] | −0.060 | [−0.027, 0.002] | ||
Food environment | ||||||||||||
Grocery density | −0.047 ** | [−0.000, −0.000] | −0.051 *** | [−0.000, −0.000] | −0.009 | [−0.000, 0.000] | −0.041 | [−0.000, 0.000] | −0.042 *** | [−0.000, −0.000] | 0.003 | [−0.000, 0.000] |
Restaurant types | 0.068 * | [0.001, 0.008] | 0.072 * | [0.001, 0.008] | −0.002 | [−0.003, 0.003] | 0.033 | [−0.002, 0.006] | 0.039 | [−0.003, 0.005] | 0.095 | [−0.000, 0.008] |
Physical activity environment | ||||||||||||
Presence of parks | 0.018 | [−0.006, 0.012] | 0.019 | [−0.005, 0.012] | −0.022 | [−0.008, 0.005] | −0.008 | [−0.009, 0.007] | 0.005 | [−0.005, 0.006] | 0.123 * | [0.003, 0.022] |
Presence of bus stops | −0.038 | [−0.015, 0.002] | −0.048 * | [−0.016, −0.000] | 0.017 | [−0.008, 0.010] | −0.039 | [−0.015, 0.004] | −0.062 | [−0.014, 0.002] | −0.083 | [−0.021, 0.004] |
Company density | −0.006 | [−0.000, 0.000] | −0.011 | [−0.000, 0.000] | 0.035 | [−0.000, 0.000] | −0.029 | [−0.000, 0.000] | 0.011 | [−0.000, 0.000] | 0.005 | [−0.000, 0.000] |
Presence of schools | −0.029 | [−0.014, 0.005] | −0.033 | [−0.014, 0.004] | −0.011 | [−0.010, 0.008] | −0.026 | [−0.013, 0.006] | −0.009 | [−0.008, 0.007] | 0.027 | [−0.010, 0.016] |
Socio−economic attributes | ||||||||||||
Age | −0.222 | [−0.011, 0.009] | −0.158 | [−0.011, 0.009] | 4.162 | [−0.001, 0.021] | −0.625 | [−0.015, 0.009] | −1.534 | [−0.016, 0.005] | 1.674 | [−0.013, 0.027] |
Education | −0.040 | [−0.002, 0.001] | −0.042 | [−0.002, 0.000] | 0.172 | [−0.000, 0.003] | −0.061 | [−0.003, 0.001] | 0.047 | [−0.001, 0.002] | 0.109 | [−0.002, 0.005] |
Employment | −0.019 | [−0.008, 0.003] | −0.020 | [−0.009, 0.003] | 0.143 * | [0.001, 0.015] | −0.043 | [−0.014, 0.003] | 0.080 * | [0.001, 0.013] | −0.089 | [−0.020, 0.003] |
Married | 0.060 * | [0.001, 0.026] | 0.061 * | [0.002, 0.026] | 0.100 | [−0.014, 0.029] | −0.045 | [−0.030, 0.013] | 0.120 * | [0.000, 0.029] | 0.088 | [−0.006, 0.036] |
Household size | 0.015 | [−0.002, 0.004] | 0.015 | [−0.002, 0.004] | 0.135 | [−0.002, 0.008] | 0.067 | [−0.001, 0.007] | 0.080 | [−0.000, 0.005] | −0.139 * | [−0.009, −0.001] |
Household income | −0.023 | [−0.003, 0.000] | −0.015 | [−0.002, 0.001] | −0.035 | [−0.003, 0.002] | −0.010 | [−0.003, 0.002] | −0.036 | [−0.003, 0.001] | −0.044 | [−0.003, 0.001] |
Wave | ||||||||||||
2004 (ref.) | ||||||||||||
2006 | 0.064 | [−0.011, 0.032] | 0.051 | [−0.012, 0.030] | −0.276 | [−0.039, 0.001] | 0.047 | [−0.020, 0.032] | 0.164 | [−0.007, 0.039] | −0.040 | [−0.047, 0.039] |
2009 | 0.087 | [−0.037, 0.066] | 0.062 | [−0.041, 0.062] | −0.688 | [−0.101, 0.012] | 0.111 | [−0.046, 0.076] | 0.322 | [−0.023, 0.085] | −0.285 | [−0.130, 0.070] |
2011 | 0.140 | [−0.047, 0.094] | 0.120 | [−0.049, 0.090] | −0.888 | [−0.136, 0.012] | 0.211 | [−0.057, 0.112] | 0.428 | [−0.034, 0.117] | −0.345 | [−0.175, 0.104] |
Attitudes | ||||||||||||
Healthy diet | 0.004 | [−0.005, 0.006] | 0.004 | [−0.005, 0.006] | 0.042 | [−0.007, 0.012] | 0.081 ** | [0.003, 0.018] | −0.048 | [−0.013, 0.005] | 0.007 | [−0.015, 0.016] |
Physically active | −0.003 | [−0.006, 0.005] | −0.002 | [−0.006, 0.005] | −0.082 | [−0.014, 0.004] | −0.037 | [−0.014, 0.004] | 0.007 | [−0.005, 0.007] | −0.020 | [−0.016, 0.012] |
N/N_neighborhood | 5479/69 | 5479/69 | 651/69 | 2196/69 | 1525/68 | 1107/69 | ||||||
LL | 9210.7 | 9236.0 | 1869.3 | 3998.6 | 3454.5 | 2403.6 | ||||||
AIC | −18,383.4 | −18,424.0 | −3690.5 | −7949.3 | −6863.0 | −4761.1 | ||||||
BIC | −18,257.9 | −18,265.3 | −3583.0 | −7812.6 | −6740.4 | −4645.9 |
Continuous Population Density | Categorical Population Density | Mediators | ||||||
---|---|---|---|---|---|---|---|---|
WHR | Physical Activity Duration | |||||||
Beta | CI | Beta | CI | Beta | CI | Beta | CI | |
Population density (Cont.) | 0.034 | [−0.001,0.003] | 0.029 | [−0.001,0.003] | −0.078 ** | [−0.132, −0.025] | ||
Population density | ||||||||
0~0.1 | 0.087 * | [0.003, 0.023] | ||||||
0.1~0.5 | 0.027 | [−0.003, 0.012] | ||||||
0.5~1 (ref.) | ||||||||
1~1.5 | −0.059 | [−0.038, 0.003] | ||||||
1.5~2 | −0.040 *** | [−0.033, −0.009] | ||||||
2~2.5 | −0.029 * | [−0.024, −0.003] | ||||||
>2.5 | 0.052 ** | [0.004, 0.028] | ||||||
Food environment | ||||||||
Grocery density | −0.046 ** | [−0.000, −0.000] | −0.050 *** | [−0.000, −0.000] | −0.046 ** | [−0.000, −0.000] | 0.028 ** | [0.001, 0.003] |
Restaurant types | 0.072 * | [0.001, 0.008] | 0.075 ** | [0.001, 0.008] | 0.068 * | [0.001, 0.008] | −0.015 | [−0.166, 0.086] |
Physical activity environment | ||||||||
Presence of parks | 0.014 | [−0.006, 0.011] | 0.015 | [−0.006, 0.011] | 0.018 | [−0.006, 0.012] | −0.020 | [−0.409, 0.134] |
Presence of bus stops | −0.042 | [−0.016, 0.002] | −0.052 * | [−0.017, −0.001] | −0.037 | [−0.015, 0.002] | 0.040 | [−0.079, 0.636] |
Company density | −0.009 | [−0.000, 0.000] | −0.014 | [−0.000, 0.000] | −0.007 | [−0.000, 0.000] | −0.018 | [−0.003, 0.001] |
Presence of schools | −0.035 | [−0.015, 0.004] | −0.038 | [−0.015, 0.003] | −0.027 | [−0.014, 0.006] | 0.033 | [−0.126, 0.559] |
Socio−economic attributes | ||||||||
Age | −0.261 | [−0.011, 0.008] | −0.180 | [−0.011, 0.009] | −0.235 | [−0.011, 0.008] | −0.359 | [−0.630, 0.447] |
Education | −0.039 | [−0.002, 0.001] | −0.043 | [−0.002, 0.000] | −0.039 | [−0.002, 0.001] | 0.016 | [−0.046, 0.071] |
Employment | −0.020 | [−0.009, 0.003] | −0.020 | [−0.009, 0.003] | −0.021 | [−0.009, 0.003] | −0.050 * | [−0.571, −0.044] |
Married | 0.063 * | [0.001, 0.027] | 0.065 * | [0.002, 0.027] | 0.060 * | [0.001, 0.026] | 0.006 | [−0.459, 0.566] |
Household size | 0.015 | [−0.002, 0.004] | 0.014 | [−0.002, 0.004] | 0.013 | [−0.002, 0.004] | −0.056 * | [−0.226, −0.029] |
Household income | −0.021 | [−0.003, 0.000] | −0.014 | [−0.002, 0.001] | −0.022 | [−0.003, 0.000] | 0.021 | [−0.016, 0.112] |
Attitudes | ||||||||
healthy diet | 0.000 | [−0.006, 0.006] | 0.000 | [−0.006, 0.006] | 0.005 | [−0.005, 0.007] | 0.040 | [−0.056, 0.579] |
physically active | 0.002 | [−0.005, 0.006] | 0.003 | [−0.005, 0.006] | −0.003 | [−0.006, 0.005] | 0.017 | [−0.238, 0.464] |
Mediators | ||||||||
Smoker | 0.018 | [−0.006, 0.012] | 0.014 | [−0.007, 0.011] | ||||
Drinker | −0.023 | [−0.010, 0.003] | −0.020 | [−0.009, 0.003] | ||||
Car ownership | 0.038 * | [0.001, 0.019] | 0.040 * | [0.001, 0.019] | ||||
Sleep duration | −0.002 | [−0.002, 0.002] | −0.005 | [−0.002, 0.002] | ||||
Physical activity duration | −0.034 ** | [−0.001, −0.000] | −0.032 * | [−0.001, −0.000] | −0.035 ** | [−0.001, −0.000] | ||
Sedentary duration | 0.033 | [−0.000, 0.000] | 0.035 * | [0.000, 0.000] | ||||
Sick | −0.007 | [−0.008, 0.005] | −0.009 | [−0.008, 0.004] | ||||
Wave | ||||||||
2004 (ref.) | ||||||||
2006 | 0.063 | [−0.010, 0.031] | 0.050 | [−0.012, 0.029] | 0.064 | [−0.010, 0.032] | 0.017 | [−0.909, 1.146] |
2009 | 0.089 | [−0.036, 0.066] | 0.061 | [−0.040, 0.061] | 0.089 | [−0.036, 0.066] | 0.062 | [−2.309, 3.182] |
2011 | 0.141 | [−0.045, 0.092] | 0.117 | [−0.048, 0.088] | 0.145 | [−0.045, 0.093] | 0.137 | [−2.757, 4.683] |
N/N_neighborhood | 5393/69 | 5393/69 | 5479/69 | 5479/69 | ||||
LL | 9109 | 9136 | 9215 | −12,086 | ||||
AIC | −18,165 | −18,210 | −18,390 | 24,210 | ||||
BIC | −17,994 | −18,006 | −18,258 | 24,336 |
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Yin, C.; Sun, B. Does Compact Built Environment Help to Reduce Obesity? Influence of Population Density on Waist–Hip Ratio in Chinese Cities. Int. J. Environ. Res. Public Health 2020, 17, 7746. https://doi.org/10.3390/ijerph17217746
Yin C, Sun B. Does Compact Built Environment Help to Reduce Obesity? Influence of Population Density on Waist–Hip Ratio in Chinese Cities. International Journal of Environmental Research and Public Health. 2020; 17(21):7746. https://doi.org/10.3390/ijerph17217746
Chicago/Turabian StyleYin, Chun, and Bindong Sun. 2020. "Does Compact Built Environment Help to Reduce Obesity? Influence of Population Density on Waist–Hip Ratio in Chinese Cities" International Journal of Environmental Research and Public Health 17, no. 21: 7746. https://doi.org/10.3390/ijerph17217746