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Linking childhood obesity to the built environment: A multi-level analysis of home and school neighbourhood factors associated with body mass index
Canadian Journal of Public Health
  • Jason A. Gilliland, Western University
  • Claudia Rangel, Western University
  • Martin Healy, Western University
  • Patricia Tucker, Western University
  • Janet E Loebach, Western University
  • Paul M. Hess, University of Toronto
  • Meizi He, University of Texas, San Antonio
  • Jennifer D. Irwin, Western University
  • Piotr Wilk, Western University
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Objectives: This study examines environmental factors associated with BMI (body mass index) levels among adolescents with the aim of identifying potential interventions for reducing childhood obesity.

Methods: Students (n=1,048) aged 10-14 years at 28 schools in London, ON, completed a survey providing information on age, sex, height, weight, home address, etc., which was used to construct age-sex adjusted BMI z-scores. The presence of recreation opportunities, fast-food outlets and convenience stores was assessed using four areal units around each participant’s home and school neighbourhood: “circular buffers” encompassing territory within a straight-line distance of 500 m and 1000 m; and “network buffers” of 500 m and 1000 m measured along the street network. School neighbourhoods were also assessed using school-specific “walksheds”. Multilevel structural equation modeling techniques were employed to simultaneously test the effects of school-environment (Level 2) and home-environment (Level 1) predictors on BMI z-scores.

Results: Most participants (71%) had a normal BMI, 16.9% were overweight, 7.6% were obese, and 4.6% were considered underweight. Multilevel analyses indicated that built environment characteristics around children’s homes and schools had a modest but significant effect on their BMI. The presence of public recreation opportunities within a 500 m network distance of home was associated with lower BMI z-scores (p<0.05), and fast-food outlets within the school walkshed was associated with higher BMI z-scores (p<0.05).

Conclusion: Interventions and policies that improve children’s access to publicly provided recreation opportunities near home and that mitigate the concentration of fast-food outlets close to schools may be key to promoting healthy lifestyles and reducing childhood obesity.


Also available open access in Canadian Journal of Public Health at:

Citation Information
Gilliland, J.A., Rangel, C.Y., Healy, M.A. et al. Linking Childhood Obesity to the Built Environment: A Multi-level Analysis of Home and School Neighbourhood Factors Associated With Body Mass Index. Can J Public Health 103, S15–S21 (2012).