Associations Between Neighborhood Amenity Density and Health Indicators Among Rural and Urban Youth

Purpose. To examine associations between the built/social environment (neighborhood amenity density, crime) and health indicators (body mass index [BMI] percentile, cardiovascular fitness, and time spent in moderate to vigorous physical activity [MVPA]) among rural and urban youth. Design. Cross-sectional. Setting. Eastern North Carolina. Subjects. Youth (n = 296) were recruited from three middle schools. Measures. Neighborhood density was estimated using Walk Score. Crime was assessed using Regional Analysis and Information Sharing online. BMI percentiles were calculated from measured height and weight. Cardiovascular fitness was estimated using heart rate measured at the conclusion of a 3-minute step test. Time spent in MVPA was measured objectively via accelerometer. Analysis. Bivariate and multivariate statistics were used to examine associations between Walk Score, crime, BMI percentile, cardiovascular fitness (as measured via heart rate), and MVPA. Results. Walk Score was positively correlated with crime. There were positive, statistically significant associations between Walk Score and (1) BMI percentile (p = .0223) and (2) heart rate (p = .0044), and (3) inverse associations between Walk Score and MVPA (p = .0042), indicating that high neighborhood density was associated with greater BMI percentiles, lower fitness, and less MVPA among urban youth. Conclusion. These counterintuitive findings may be due to the negative effect of crime on health indicators, which may outweigh potential positive health impacts of high neighborhood amenity density.