Evaluating the Impact of Social, Economic, and Built Environmental Factors on Obesity and Walkability

Research has demonstrated a relationship between neighborhood walkability and obesity prevalence; greater walkability is generally linked to increased physical activity and thus lower obesity prevalence. Datasets from the Centers for Disease Control and Prevention (CDC) PLACES: Local Data for Better Health (2023); the United States (US) Environmental Protection Agency (EPA); the US Department of Agriculture (USDA) Food Access Research Atlas (2019); and the Agency for Healthcare Research and Quality (AHRQ, 2020) were merged by census tract and filtered to include only Texas data. There was a total of 5222 census tracts, but 1470 observations with missing data on key variables were removed, yielding a final sample of 3752 census tracts. The mean obesity prevalence was 36.1%, while walkability scores averaged 9.1. Higher obesity prevalence was observed in less walkable and socioeconomically disadvantaged tracts. When conducting multivariable linear regression, race, ethnicity, education levels, and region were significant predictors; the final model displayed strong explanatory power (R2 = 0.79; cross-validated R2 = 0.77). Overall, higher walkability scores were associated with lower obesity prevalence, but the association was weak; socioeconomic status, food access, educational level, demographics, and comorbidities were strongly associated with obesity prevalence.