Design For Health

Research: High Density and Overweight Adolescents

I typically don’t report on scholarly studies in this blog but recently came across a nicely designed study that makes a larger point—that the links between health and place are complex. Fei Xu, JieQuan Li, YaQiong Liang, ZhiYong Wang, Xin Hong, Robert S Ware, Eva Leslie, Takemi Sugiyama, and Neville Owen have produced a report  on the Nanjing High School Students’ Health Survey, published in the Journal of Epidemiology and Community Health in 2010 (64, 1017-1021, http://jech.bmj.com/content/64/11/1017). Titled: “Residential density and adolescent overweight in a rapidly urbanising region of mainland China” the study used data collected from 2,375 adolescents in 2004 to examine the relationship between (large-scale) district level densities and weight.

New high rise behind village
residences in suburban Shanghai, 2010

Densities are reported per square kilometer but in range from 5 persons per hectare to 307.  The study divided the sample into high, medium, low density residents. Youth in the middle and higher density areas (that is over > 35 person per hectare) were roughly  twice as likely to be overweight.

The relationship was reduced a bit but still significant after controlling for TV time, study time, recreation, age, gender, and parents education. Physical activity data came from self reports through a version of the International Physical Activity Questionnaire (IPAQ) that only asked about some kinds  of activities. Given a lack of data on overall physical activity and food intake the authors speculate on a number of reasons for this difference e.g. youth in higher density and potentially higher income areas eating more, higher density areas having less recreational space, or (and here I am paraphrasing quite loosely) that higher density areas may just be too convenient with too much internet access so youth don’t have to expend much energy getting places. The high densities in China are also quite high compared with the US and Australia in particular, where much research has been done. They are also increasing rapidly—the authors report overall densities in Nanjing, presumably including some rural districts, increasing from 14 persons per hectare in 1997 to 23 in 2007.

The study is interesting because in many studies of adults, those in higher densities walk more for transportation (though they may not walk more overall) and some find they are thinner (though not all studies measure this or find it to be true, including my own). In this study of youth, with a large group and fairly good measures, those in higher densities are chubbier. While it is important not to make too much of one study, this is yet another example of the complexity of the relationship between health and place, and the importance of social factors.

Tools: The National Collaborative for Childhood Obesity Research Catalog of Surveillance Systems

The National Collaborative for Childhood Obesity Research is a group spearheaded by the National Institute of Health, Centers for Disease Control, and Robert Wood Johnson Foundation. The Catalog of Surveillance Systems is a new product, also sponsored by the USDA. The catalog provides a searchable database of ongoing monitoring systems related to health. It includes both public systems such as the Census of Agriculture and National Vital Statistics System and private ones such as the Nielsen Homescan and InfoUSA.com. In all, 77 systems are represented.

The database can be filtered by keywords related to the level (person to community to policy), scope (local, state, national), key health variables, age groups, ethnicity, research design, and cost to use.

Each system has an individual entry including information on distinctive characteristics, sampling, key variables, costs, whether information is linked to geographical databases or to other surveys, example publications using the data, and other resources.

This is an extremely useful database and can provide a quick point of entry for those interested in assessing what data are available.

Tools: Food Security Assessments


Oakland, California (Photo by Ann Forsyth)
The topic of food and planning is one of great interest—particularly promoting healthy food options. Of course what people eat is a complicated result of their personal preferences, financial resources, and social context. Food availability depends on climate, the time of year, whether people grow their own food, how much it costs, home food storage options, and the kinds of stores in the local area.
However, a number of tools can help larger communities plan for their food access.
  • One such tool is the Food Security Assessment. In 2002, the USDA Economic Research Service published a well-known Community Food Security Toolkit: http://www.ers.usda.gov/Publications/EFAN02013/ with the entire toolkit at http://www.ers.usda.gov/publications/efan02013/efan02013.pdf. There are other toolkits around, with many good tools developed for use internationally in areas likely to suffer substantial food shortages, but this one by aU.S. government agency may be a good place for others to start.
  • The USDA web site provides helpful information about food security in the U.S.: http://www.ers.usda.gov/Briefing/FoodSecurity/. A 2007 USDA Food Security Assessment provides an example at the international level: http://www.ers.usda.gov/Publications/GFA19/. However, using the methods in the toolkit, local communities can do this as well.
The food security assessment and other food related tools are discussed in the DFH Food Issues Sheet at http://designforhealth.net/wp-content/uploads/2012/12/Information_Sheet/BCBS_ISFood_090107.pdf based on research outlined in the Food Key Questions research summary http://designforhealth.net/wp-content/uploads/2012/12/Key_Questions/BCBS_KQFood_082207.pdf.
Search DFH
Blog Archives
DFH Networks