Purpose: Examine whether individual-level childhood obesity is related to residential availability of fast food and healthy food outlets.
Design: Retrospective cross-sectional study.
Setting: Perth, Western Australia.
Subjects: A total of 1850 children aged 5 to 15 years in 2005-2010 who participated in the Western Australian Health and Wellbeing Surveillance System survey.
Measures: Geographical Information Systems were used to calculate a range of measures of fast food and healthy food outlet access and availability. For example, distance to nearest and access and density measures within 800 m and 3 km of each child's residence were all tested.
Analysis: Multivariate logistic regression analysis, controlling for individual-level sociodemographic factors and lifestyle behaviors.
Results: An increasing number of healthy food outlets within 800 m of a child's home was associated with a significantly reduced risk of being overweight/obese in all models tested. After controlling for age, physical activity, time spent sedentary, weekly takeaway consumption, area disadvantage, and count of fast food outlets, each additional healthy food outlet within 800 m was associated with a 20% decrease in the likelihood of a child being overweight or obese (odds ratio: .800, 95% confidence intervals: .686-.933).
Conclusion: The local food environment around children's homes has an independent effect on child weight status. These findings highlight the importance of the built environment as a potential contributor towards child health, which should be considered when developing community health promotion programs.
Keywords: Health focus: nutrition; Obesity, Child, Fast Food, Healthy Food, GIS, Logistic Models, Prevention Research. Manuscript format: research; Outcome measure: morbidity; Research purpose: modeling/relationship testing; Setting: local community; Strategy: built environment; Study design: nonexperimental; Target population age: youth; Target population circumstances: geographic location.