Effects of Built Environment on Obesity: Using a Propensity Score Approach to Assess Selection and Causal Influences

Barbara Brown, University of Utah
Jessie Fan, University of Utah
Ikuho Yamada, University of Utah
Cathleen Zick, University of Utah

Obesity and overweight are major public health problems. An estimated 65% of US adults are overweight or obese with up to 280,000 annual deaths attributable to obesity. In an effort to understand factors associated with adult obesity/overweight, attention has recently focused on the potential effects of environmental influences. Yet, studies linking the physical environment to the risk of being overweight or obese are limited by the fact that residents are not randomly distributed by neighborhood. Our prior research (Smith et al, 2008) has identified several features of the built environment to be important in influencing overweight status among adults. However, this paper did not address the possibility of non random selection into neighborhoods and how that might influence the results. As a result, we adopt a propensity score approach to test for the robustness of the previously reported associations of neighborhood housing age with risk of overweight status.