Walking the walk: Income inequality, neighborhood walkability and obesity in Hispanic adults

The increase in rates of obesity in recent years presents a significant public health challenge with approximately 69 percent of adults classified as overweight using data from 2011-2012, leading to an explosion in health care costs and contributing to heart disease, diabetes and other conditions. Increasing physical activity is one way to slow the obesity epidemic. Previous research has shown that community factors such as income inequality and neighborhood walkability affect physical activity rates, but studies have been limited to single cities or otherwise had a narrow scope.

A new study by Samuel D. Towne, PhD, MPH, assistant professor at the Texas A&M School of Public Health, and colleagues aimed to fill in gaps in this research by looking at individual and community factors among Hispanic adults in seven Texas cities. The Hispanic community was of interest as it has higher rates of obesity (40 and 46 percent for males and females, respectively) than the average of adults in the United States (35 and 36 percent for males and females, respectively). “There is a critical need to identify sustainable solutions to help combat obesity and related health issues in the United States” Towne said. “Modifying the built environment to help make physical activity more attractive may be one possible solution to help address gaps in physical activity and related issues such as obesity.”

This research, published in the Journal of Immigrant and Minority Health, focused on the role that income inequality and neighborhood walkability play in obesity and physical activity rates. The researchers gathered data on 377 low-income Hispanic adults whose children were in a garden and nutrition program for third graders and who were eligible for free or reduced-price lunch. Researchers used the body mass index of the subjects and self-reported data on how many days they had walked at least 30 minutes during the previous week as measures of health outcomes and behaviors. They then calculated income inequality levels from the U.S. census and how walkable each neighborhood was using a publicly available walkability index known as Walk Score^®.

The study measured the effects of income inequality on health outcomes, comparing rates of obesity among different levels of inequality. The researchers found that people living in neighborhoods with higher levels of income inequality were more likely to be obese than people in low income inequality neighborhoods, even after controlling for other factors. The researchers also analyzed physical activity levels and neighborhood walkability. They found that about one third of the people in the study did not walk at least 30 minutes a day during the week and that twice as many of those subjects lived in neighborhoods that would be considered car dependent and not walkable. On the other hand, people living in walkable neighborhoods reported 50 percent more walking days than those in moderately or heavily car dependent areas.

These results are consistent with previous studies focusing on more limited areas or on different racial and ethnic groups and helps fill in gaps in the body of knowledge in this area. The study’s findings suggest that higher levels of income inequality might be useful predictors of obesity and that a neighborhood’s walkability is associated with physical activity levels. Further research is needed to explore neighborhood details such as land use and population density and factors like number of chronic health conditions.

The self-reported nature of the data and small size of the study limits how much the findings can be generalized across the population, but it does point to key areas of focus for future public health efforts.

“Identifying sustainable environmental interventions, like modifying or building communities to be more walkable, may help increase physical activity for at-risk populations,” Towne said. “Policies to improve the walkability of neighborhoods, such as building walkways and paths, could help reduce obesity levels, though further research will be needed to build targeted interventions and information campaigns.”