Healthy urban environment characterization focused on physical activity and food: A GIS-based method

In response to the emerging challenge of the obesity epidemic, as highlighted by the World Health Organization, public health policies and programs are focusing on promoting changes in the urban environment. Healthier urban... [ view full abstract ]

In response to the emerging challenge of the obesity epidemic, as highlighted by the World Health Organization, public health policies and programs are focusing on promoting changes in the urban environment. Healthier urban environments may influence the distribution of cardiovascular risk factors. The aim of the present study was to design and implement a multivariate method based on a Geographic Information System (GIS) to characterize and evaluate the environmental correlates of obesity: the food and the physical activity urban environment. The study was conducted in a sociodemographically average urban area of Madrid (Spain), comprised of 12 contiguous census sections (≈16.000 residents total). Data were gathered through on-field auditing of all food stores and street segments present in the study area. We designed a synthetic index integrating continuous measures of both food and physical activity environments, generated by kernel density analyses. The synthetic index ranges from 0 to 100, being 0 least healthy. We found a heterogeneous distribution with 75% and 50% of the area scoring less than 36.8 and 25.5 respectively. As the Spanish official statistical data are aggregated by census sections, the study area were characterized following a range from high to low through a zonal analysis. Thus, 4.2% of the population lives in a healthy area while 41.0% is in an unhealthy place. Most of the population (52.8%) is located in an area with a median score, 29.1% medium-high and 26.6% medium-low. Our results highlight the need to consider urban environments as promoters or barriers for healthy behaviors such as better eating and being physically active. This synthetic index may be relevant tool to inform future urban health interventions.