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How Neighborhood Environments Contribute to Obesity

 Until recently, researchers have focused most of their attention on psychosocial factors that contribute to obesity and related behaviors, such as diet and physical activity.1, 2 However, there is increasing recognition of the important role that environmental factors play in these behaviors.
Between 1980 and 2000, the age-adjusted prevalence of obesity doubled, rising to 31% of U.S. adults, ages 20 to 74.3 Since then, the prevalence rate has continued to rise.4 Obesity is a major health concern among African Americans; the prevalence of obesity in African American women exceeds rates for all other racial, ethnic, and gender groups (for example, 54% of African American women are obese, compared with 30% of non-Hispanic white women).4 Nurses, too, find excess weight gain a common health challenge.5, 6
Nurses who work in both clinical and community settings are often responsible for educating clients on the benefits of better diet and increased physical activity in the prevention and treatment of obesity. But education alone rarely produces the desired results. Behavior change may be particularly challenging for those who live in low-income and minority neighborhoods where the resources needed to maintain healthy lifestyles are limited and health risks are widespread.7–10
Consequently, we have focused our research on how urban neighborhood environments may contribute to racial and ethnic disparities in obesity prevalence among women. This article describes studies conducted by an interdisciplinary team of researchers (including a nurse researcher, first author SNZ) to understand how environmental factors, including the availability of different kinds of food, influenced the diet of African Americans living in several Chicago and Detroit neighborhoods. (We use a term often seen in the literature, neighborhood food environment, to refer to a group of factors including the types of retail food outlets and the availability, quality, and price of different kinds of foods, such as prepared foods, fresh produce, and other groceries, in a given geographical area.) This research entailed working in community–academic partnerships composed of academic researchers, health service providers, and members of local community organizations.11, 12 Our long-term goal is to create urban environments that support healthy eating.