Parks, Environmental Justice, & Childhood Obesity

Parks, Environmental Justice, and Childhood Obesity 

Project Summary

Picture134Youth obesity is a major public health concern due to the wide array of physical, social, and emotional health consequences that often accompany overweight and obese youth during childhood and even into adulthood. Alarmingly, the prevalence of childhood and adolescent obesity has increased over the past three decades with a disproportionate burden on youth that are low-income, racial/ethnic minorities, and reside in the southeastern United States. Policy, systems, and environmental (PSE) strategies are increasingly recognized as promising approaches for increasing active living and reducing obesity rates among youth. Within this paradigm, parks are key community assets for promoting physical activity and health, especially among youth. However, to support the development of a comprehensive strategy for addressing obesity and chronic diseases through parks, solid information is needed about the current state of resources in communities and the impact these open spaces are having on youth physical activity participation, obesity rates, and overall health.

Environmental justice, broadly speaking, refers to the idea that no group should bear a disproportionate burden of the causes (e.g., lack of parks) or consequences (e.g., obesity) of environmental health issues. Numerous factors contribute to lower rates of physical activity among low income and minority residents, including lower education levels, less disposable income, and stress and fear associated with racism and poverty. However, another significant issue may be disparities in access to environmental resources that facilitate physical activity. This is an issue related to environmental justice and has been referred to as “deprivation amplification,” wherein persons with fewer personal resources that might support physical activity (e.g., income, knowledge) also tend to reside in areas that are more deprived of neighborhood physical activity resources (e.g., sidewalks, parks). Indeed, numerous studies have investigated this idea of ‘park deserts’ and have supported the idea that inequalities often exist by various sociodemographic indicators. Given the importance of parks to physical activity participation and to building healthy communities, a lack of access to quality park environments is a serious problem that has the potential to exacerbate rates of obesity and chronic disease among children, adults, and seniors from the most vulnerable backgrounds.

Study Aims: 

  1. To examine whether the availability, features, and quality of parks are equitably distributed across the study area according to a variety of demographic indicators (income, race/ethnicity, education level, youth population, etc.)
  2.  To examine the relationship between park availability, features, and quality and obesity levels among youth in the study County.
  3.  Explore global and local spatial clustering of youth obesity in the study County and determine which individual and neighborhood characteristics are related to spatial clustering of youth obesity
  4. Develop a measure of obesogenic environments that incorporates density measures of the park and food environment and examine the associations between obesogenic environments and youth obesity in the study County

This project represents a partnership between the University of South Carolina, six parks and recreation departments across Greenville County, LiveWell Greenville, and Furman University.

This study has been funded by the Piedmont Health Foundation, University of South Carolina Office of the Provost and the University of South Carolina Office of the Vice President for Research SPARC Graduate Research Grant Program.
Aim 1
To examine whether the availability, features, and quality of parks are equitably distributed across the study area according to a variety of demographic indicators (income, race/ethnicity, education level, youth population, etc.)

To accomplish Aim 1, we combined geographic mapping and observational audits of all public parks across Greenville conestee-parkCounty  to examine the whether park availability and quality was equitable across neighborhoods of different racial/ethnic and socioeconomic status. Information about a variety of demographic characteristics was downloaded for each census block group in Greenville County from the American Community Survey (2008-2012) conducted by the U.S. Census Bureau. All publicly accessible parks were mapped using geographic information systems (GIS) technology to determine the number and total area of parks that intersect each census block group. We also conducted on-site audits of all parks in the city using the Community Park Audit Tool (CPAT), which was recently developed by Dr. Kaczynski through a grant from the Robert Wood Johnson Foundation. Using data collected from the CPAT, we will be able to assess the availability of park facilities and amenities and the level of park quality across diverse census block groups. All analyses took into account factors such as the size of the census block group, the total population, and the percentage of population less than 18 years of age. All of this information was displayed both statistically (e.g., percentages, correlations) and spatially (e.g., maps) to show the relationship between the demographic (income, race, etc.) composition of neighborhoods in Greenville and the availability and quality of parks. Please see linked presentations and publications below.

Conferences

  • Hughey, S.M., Walsemann, K.M., Child, S., & Kaczynski, A.T. (2015, June). Quality matters: Examining the relationship between neighborhood socioeconomic disadvantage and park availability and quality in a semi-urban County in the southeastern United States. Presented at the International Society of Behavioral Nutrition and Physical Activity Annual Meeting, Edinburgh, Scotland
  • Hughey, S.M., Hibbert, J., Reed, J.A., & Kaczynski, A.T. (2014, September). Exploring disparities in obesogenic environments: Park availability, features, and quality in Greenville County, SC. Presented at the 2nd Annual Southeastern Conference Obesity Symposium, Atlanta, GA.

 Publications

  •  Hughey, S.M., Walsemann, K.M, Child, S.T., Powers, A., Reed, J.A., & Kaczynski, A.T. (2016). Quality matters: Examining the relationship between neighborhood socioeconomic disadvantage, racial composition, and park availability and quality. Landscape and Urban Planning, 148, 159-169.
Aim 2
To examine the relationship between park availability, features, and quality and obesity levels among youth in the study County

Parks are critical components of healthy communities and can positively influence youth physical activity and potentially reduce obesity levels. Despite national-level efforts, childhood obesity rates remains high, with youth of low socioeconomic status (SES) and racial/ethnic minority backgrounds disproportionately affected. Some researchers have suggested that inequities in neighborhood built environment resources may contribute to disparities in youth obesity. However, relatively few studies have explored this hypothesis and assessed associations between specific park features, like playgrounds, and obesity. Even less research has been conducted to ascertain whether the relationship between park and playground availability and youth obesity is moderated by race/ethnicity or SES. Therefore, the purposes of this study were: 1) to examine associations between neighborhood park and playground availability and youth obesity, and 2) to assess whether these associations are moderated by youth race/ethnicity and SES.

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Conferences 

  • McCarthy, S., Hughey, S.M., Kaczynski, A.T. (2016, April). The role of accessibility and quality of public playgrounds on childhood obesity in Greenville County. Presented at the University of South Carolina Undergraduate Discovery Day.
  • Hughey, S.M., Kaczynski, A.T., Child, S., Moore, J.B., Porter, D., & Hibbert, J. (2016, February) Green and lean: Is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity. Presented at the Active Living Research Annual Conference, Clearwater, FL

Publications

  • Hughey, S.M., Kaczynski, A.T., Child, S., Moore, J.B., Porter, D., & Hibbert, J. (revised and resubmitted). Green and lean: Is neighborhood park and playground availability associated with youth obesity? Variations by gender, socioeconomic status, and race/ethnicity. Manuscript submitted for publication, Invited for submission for Active Living Research Special Issue of Preventive Medicine.
  • McCarthy, S., Hughey, S.M., & Kaczynski, A.T. (under review). Is playground quality and accessibility linked with healthy weight status in youth? Manuscript submitted for publication
Aim 3 
Explore global and local spatial clustering of youth obesity in the study County and determine which individual and neighborhood characteristics are related to spatial clustering of youth obesity

Examining the determinants of childhood obesity is imperative to understand how to address and prevent the epidemic at a community level. Although epidemiological patterns of youth obesity across the U.S. have been established, fewer studies have examined spatial patterns of youth obesity at a local level. Among research that has explicitly employed spatial clustering methodology, very few studies have examined obesity patterns, particularly in youth. Investigating the geographic distribution of youth obesity at a local level is critical to 1) identify areas that have high rates and clustering of youth obesity,  2) explore whether the distribution of youth obesity is completely random or whether individual and area characteristics predict the observed patterns, and 3) determine whether geographic spatial clustering is contributing to observed disparities in youth obesity according to race/ethnicity and SES. Furthermore, the identification of geographic areas that have clustering of youth obesity may be particularly useful for pinpointing priority areas for public health intervention. The development of maps via GIS software that correspond with identified priority areas can be a powerful tool for both community leaders and residents to better understand the location and contributing factors for obesity across neighborhoods. These tools can substantially contribute to discourse and action to creating healthier communities.

spatial-clustering

 

Aim 4
Develop a measure of obesogenic environments that incorporates density measures of the park and food environment and examine the associations between obesogenic environments and youth obesity

environmentMany studies have provided foundation evidence for understanding the influences of park and food environments separately as well as potential mechanisms to explain how environments influence dietary behavior, active behaviors, and weight status. However, it is critical that research include environmental influences for both sides of the energy balance equation to further explicate how these community features impact youth weight status. Therefore, unlike the vast majority of literature related to obesogenic environments and youth weight status, this project will combine the park and food environment together, by creating a scoring measure for the total obesogenic environment as one of the primary independent variables. When creating this measure, we will use density estimations that accurately represent data that changes across space and these measures will also give greater weight to more proximal features. These density measures have been used less frequently in the literature, thought they can highlight how closer and higher ‘ranked’ features are more impactful than features further away or with a lower ‘score’. Then, we will examine the associations between obesogenic environments and youth obesity outcomes. Overall, this study is innovative by incorporating multiple comprehensive and detailed datasets together in a unique way to measure exposure to built environment features.

 

Conferences  & Publications

As a result of this multistage project, we have had the opportunity to share this innovative program and results in several different academic and professional outlets. Please see the reference and links for these various presentations and papers below each aim above.

 Project Team

For more information about this project, feel free to contact us:

Morgan Hughey, MPH
University of South Carolina
morganhughey@gmail.com

Andrew Kaczynski, PhD
University of South Carolina
atkaczyn@mailbox.sc.edu

Shea McCarthy
University of South Carolina
sheamm@email.sc.edu