1. International Health Policy Program -Thailand The effect of neighborhood environments and the risk of obesity Kitiporn Tupsart

2. International Health Policy Program -Thailand 2 Hypothesis Neighbourhood characteristics are associated with an individual’s body mass index (BMI) and obesity risk – Local food environment – Neighbourhood walkability – Low income and Non-low income neighbourhood

3. International Health Policy Program -Thailand Methods Use data from Utah Population database merged with U.S.Census data and Dun and Bradstreet business data for Salt Lake country, Utah Sampling-Adults aged 25-64 years who have driver license or driving privilege card with an address that can be geo- coded – exclude young adults who have not likely not established their post adolescence residence and elderly adults for whom BMI is likely to have more complex associations with health Sample size-453,927 persons

4. International Health Policy Program -Thailand 4 Results Neighborhood physical environment are associated with BMI and obesity risk in both low and non low income neighborhood Increasing in population density associated with reducing of BMI and obesity risk in both, low and non low income neighborhood, but greater in low income neighborhood.

5. International Health Policy Program -Thailand 5 Results Neighborhood retail food options strong associated with BMI/obesity risk, with the magnitude of effects varying by neighborhood income There was no relationship between proximity to fast food outlets and BMI/ obesity risk, however, there was a significant relationship between the presence of healthy grocery store and reduce BMI/ obesity risk in low income neighborhood

6. International Health Policy Program -Thailand 6 Walkability indicators of older neighborhoods and neighborhood where a higher fraction of the population walks to work is related to a lower BMI/ obesity risk Surprisingly, walkability indicator of neighborhoods with higher intersection density was linked to higher BMI/obesity risk Results

7. International Health Policy Program -Thailand 7 Reference Cathleen D. Zick, Ken R. Smith, Jessie X. Fan, Barbara B. Brown, Ikuho Yamada, Lori Kowaleski- Jones. Running to the store? The relationship between Neighborhood environments and the risk of obesity. Social Science & Medicine Vol. 69, Issue 10, P. 1417-1560 (November 2009).

8. International Health Policy Program -Thailand 8 Thank you