Environmental and Social Contributors to Overweight and Obesity

Overweight and obesity are complicated medical conditions that encompass physical, emotional, behavioral, economic, cultural and genetic components.  And because of the inter-relationships among some of these factors, it is often difficult to tease out the specific contributions of each of these factors to someone being overweight or obese.  Many studies have attempted this task, but the evidence remains equivocal.  Below are some examples of the range of findings from peer-reviewed published literature. Please note that some of the studies mentioned reflect data from populations outside the US.

Individual and Family Characteristics:

Socioeconomic status has been implicated in overweight and obesity either directly or because of related issues, such as:

• Nutrition (7, 12, 16, see also Contributors: Nutrition within this site)
• Physical activity (1,3, 12, see also Contributors: Physical Activity within this site)
• Education of both subjects and parental education (7, 11, 17)
• Being in a poor neighborhood and its correlates of more expensive food and lack of access to facilities (3)
• Homeownership – as an indicator of material resources -- was associated with lower prevalence of obesity. (11)

Income: Income can be a factor in overweight and obesity for several reasons: (12)

• People with low income must balance food purchases with other household expenses;
• Cheaper foods are often higher in fat and sugar;
• Food in low-income areas has been shown to be higher than in higher income areas.
• People with low incomes may not be able to travel to areas where food costs are lower (16).
• Childhood economic difficulties was associated with high levels of obesity in women. (11)

Social Factors:

• Social supports and self-efficacy in African American girls appear to be positively inversely related to overweight and obesity: the more social supports and/or the higher an individual’s sense of self-efficacy, the less likelihood of being overweight or obese. (1)
• Studies are mixed on whether children’s perceptions of parental support for physical activity is related to the child’s self-reported level of physical activity. (1)
• Collective efficacy within communities – that is, the degree to which people look out for each other – has been associated with lower BMI, lower risk of overweight and less overweight status in adolescents. (6)
• In one study, a lower prevalence of obesity with cohabitation of people of both genders. (8)
• Length of residency in the US was negatively associated with obesity in Hispanic immigrants.  New immigrants had lower prevalence of obesity than their Hispanic counterparts in the US, but that difference decreased over time, likely owing to changes in dietary patterns. (9)

Family and Parental Characteristics:

• Children of overweight or obese parents are more likely to be overweight. (2, 7, 11)
• Children growing up in families that model sedentary lifestyle or poor health behaviors (smoking, poor nutrition, low physical activity) are more likely than their counterparts to become overweight as children or as adults. (13, 14)
• Children who are overweight or obese in childhood are more likely to be overweight or obese as adults.
• Parental education can be a factor in childhood overweight and obesity. (7, 11)

Neighborhood, Community and Work Environments

• There is mixed evidence on whether perception of neighborhood safety and access to facilities is related to physical activity and by extension to weight or BMI. (1,2,3,4,5)
• Numerous research studies have found a relationship between neighborhood characteristics and/or the general environment and obesity. (2,3)
• Studies have also found no relationship between perception of neighborhood safety and obesity (4)
• Environment factors and design of the built environment can shape lifestyle issues -- access to or safety of physical exercise, acceptability of smoking, television viewing and so forth), which are implicated in overweight and obesity for children, adolescents and adults. (3, 4, 10, 15, 17)
• Neighborhood safety has been associated with:
• Television viewing (but not outdoor play or obesity). (4)
• Level of physical activity (5, 10)
• Traffic and road safety (15)
• The Surgeon General’s Call to Action makes recommendations and action steps to address environmental factors that may contribute to overweight or obesity.

Selected Peer-Reviewed Articles

Adkins S, Sherwood NE, Story M, Davis M. Physical activity among African-American girls: the role of parents and the home environment. Obes Res. 2004 Sep; 12 Suppl:38S-45S. 

Blanchard CM, McGannon KR, Spence JC, Rhodes RE, Nehl E, Baker F, Bostwick J. Social ecological correlates of physical activity in normal weight, overweight and obese individuals. Int J Obese (Lond) 2005 Jun;29(6):720-6.

Booth KM, Pinston MM, Poston WS. Obesity and the built environment. J. Am Diet Assoc. 2005 May; 105(5 Suppl 1):S110-7.

Burdett HL and Whitaker RC. A national study of neighborhood safety, outdoor play, television viewing and obesity in preschool children.  Pediatrics 2005 Sep 116(3):657-62.

CDC. Perceptions of neighborhood characteristics and leisture time-physical activity – Austin/Travis County, Texas, 2004.  MMWR Morb Mort Weekly Rep 2005 Sep 23;54(37):926-8.

Cohen DA, Finch BK, Bower a, Sastry N. Collective efficacy and obesity: the potential influence of social factors on health. Soc Sic Med. 2006 Feb;62(3):769-78 Epub. 2005 Jul 21. 

Henderson VR and Kelly B. Food advertising in the age of obesity: content analysis of food advertising on general market and African American television. J Nutr Educ Behav 2005 Jul-Aug; 37(4):191-6.

Ichinohe M, Mita R, Saito K, Shinkawa H, Nakaji S, Coombs M, Carney A, Wright B, Fuller EL.  The prevalence of obesity and its relationship with lifestyle factors in Jamaica. Tohoku J Exp Med 2005 sep:207(1):21-32. 

Kaplan MS, Huguet N, Newsom JT, McFarland BH. The association between length of residence and obesity among Hispanic immigrants. Am J Prev Med. 2004 Nove;27(4):323-6. Study shows that newly arrived immigrants are healthier than their US born counterparts, but this advantage diminishes as immigrants have longer residency in the US.

King WC, Belle SH, Brach JS, Simkin-Silverman LR Soska T and Kriska AM. Objective measures of neighborhood environment and physical activity in older women. Am J Prev Med 2005 Jun:28(5):461-9.

Laaksonen M, Sarlio-Lahteenkorva S, Lahelma E. Multiple dimensions of socioeconomic position and obesity among employees: The Helsinki Health Study. Obes Res. 2004 nov;12(11):1851-8.

Le Petit C, Berthelot JM. Healthy Today, Healthy Tomorrow: Findings from the Nantional Health Population Survey, Issue Brief #3: Obesity: A Growing Issue, Statistics Canada

Provencher V, Perusse L, Bouchard L, Drapeau V, Bouchard C, Rice t, Rao DC, Tremblay A, Despres JP Lemiuex S. Familial resemblance in eating behaviors in men and women from the Quebec family study. Obes Res 2005 sep:13(9):1624-9.

Ritchie LD, Welk G, Styne D, Gerstein DE Crawford PB. Family environment and pediatric overweight: what is a parent to do? J Am Diet Associ 2995 May:105(5 Suppl 1):S70-9.

Timperio A, Salmon J, Telford A, Crawford D. Perceptions of local neighbourhood environments and their relationship to childhood overweight and obesity. Int J Obes (Lond). 2005 Feb;29(2):170-5.

Travers KD. The social organization of nutritional inequities. Social Science and Medicine 1996; 43(4): 543-53.

Wakefield J. Fighting obesity through the built environment.  Envir Health Perspec 2004 Aug; 112(11):A616-A618.

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