ZIP Code as Important as Genetic Code in Childhood Obesity

Neighborhood supermarket and park proximity directly related to obesity, study finds


Nearly 18 percent of U.S. school-aged children and adolescents are obese, as the rate of childhood obesity has more than tripled in the past 30 years. The prevalence of obesity puts children at greater risk of developing heart disease, type 2 diabetes, stroke and other illnesses, and of suffering severe obesity as adults. New study results indicate that where a child lives, including factors such as the neighborhood’s walkability, proximity to higher quality parks, and access to healthy food, has an important effect on obesity rates. Researchers found that children living in neighborhoods with favorable neighborhood environment attributes had 59 percent lower odds of being obese.

“Obesogenic Neighborhood Environments, Child and Parent Obesity: The Neighborhood Impact on Kids Study” was published in a special theme issue of the American Journal of Preventive Medicine. Led by Brian Saelens, PhD, of Seattle Children’s Research Institute, this is among the first neighborhood environment studies to look at a combination of nutrition and physical activity environments and to assess children and their parents. It is also among the largest studies of its kind to use objective geographic information system (GIS) data to examine the physical activity and healthy food option attributes of a neighborhood related to obesity.

Researchers used GIS to assess Seattle and San Diego area neighborhoods’ nutrition and physical activity environments. Nutrition environments were defined based on supermarket availability and concentration of fast food restaurants. Physical activity environments were defined based on environmental factors related to neighborhood walkability and at least one park with more or better amenities for children. Kids that lived in neighborhoods that were poorer in physical activity and nutrition environment had the highest rates of obesity—almost 16 percent—in the study. This figure is similar to the national average. On the flip side, only eight percent of children were obese in neighborhoods where physical activity and nutrition environments were positive.

“People think of childhood obesity and immediately think about an individual’s physical activity and nutrition behaviors, but they do not necessarily equate obesity with where people live,” said Dr. Saelens, who is also a professor of pediatrics at the University of Washington. “Everyone from parents to policymakers should pay more attention to zip codes because they could have a big impact on weight.”

Fast food may not be as easy to come by in the Seattle area, based on the study. There were 3,474 fast food locations in San Diego County, as compared to 1,660 in King County, Wash. On a county-level block group average basis, San Diego had 2.0 fast food locations per block group, and King County had 1.1.

Numerous national health organizations have identified neighborhood environment and built environment, including healthy food and physical activity opportunities, as important factors in childhood obesity, including the Institute of Medicine and the Centers for Disease Control and Prevention. “Our data support recommendations from these groups that we need to change our environments to make them more supportive of physical activity and nutrition,” said Saelens.

Dr. Saelens’ co-authors were: James Sallis, PhD, University of California San Diego; Lawrence Frank, PhD, University of British Columbia; Sarah Couch, PhD, RD, University of Cincinnati; Chuan Zhou, PhD, Seattle Children’s Research Institute; Trina Colburn, PhD, Seattle Children’s Research Institute; Kelli Cain, MA, University of California San Diego Research Foundation; James Chapman, MSCE, Urban Design 4 Health, Inc.; Karen Glanz, PhD, MPH, University of Pennsylvania.

Supporting Materials

  • Press Release: Seattle Children's Recommends Strategies for Reducing Childhood Obesity Rates
  • Institute of Medicine Report: Preventing Childhood Obesity: Health in the Balance http://www.nap.edu/openbook.php?isbn=0309091969
  • Institute of Medicine Report Brief: Local Government Actions to Prevent Childhood Obesity

About Seattle Children’s

Seattle Children’s mission is to provide hope, care and cures to help every child live the healthiest and most fulfilling life possible. Together, Seattle Children’s Hospital, Research Institute and Foundation deliver superior patient care, identify new discoveries and treatments through pediatric research, and raise funds to create better futures for patients.

Ranked as one of the top children’s hospitals in the country by U.S. News & World Report, Seattle Children’s serves as the pediatric and adolescent academic medical center for Washington, Alaska, Montana and Idaho – the largest region of any children’s hospital in the country. As one of the nation's top five pediatric research centers, Seattle Children’s Research Institute is internationally recognized for its work in neurosciences, immunology, cancer, infectious disease, injury prevention and much more. Seattle Children’s Hospital and Research Foundation works with the Seattle Children’s Guild Association, the largest all-volunteer fundraising network for any hospital in the country, to gather community support and raise funds for uncompensated care and research.

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