London School of Hygiene & Tropical Medicine

Where you live and how you view your neighbourhood is strongly related to your risk of developing obesity, according to new research published in a special issue of the journal Obesity Reviews.

The results come from the four-year €3.7 million 'Sustainable Prevention of Obesity through Integrated Strategies' (SPOTLIGHT) project, carried out by a cross-European team of researchers, including experts from the London School of Hygiene & Tropical Medicine.

The project investigated how certain environments may be more 'obesogenic' than others - more likely to encourage unhealthy behaviours that lead to weight gain, such as sedentary lifestyle and excessive calorie consumption. The researchers looked at local neighbourhoods in cities across Europe, using people's self-reported perceptions of their environment, and objective measures based on Google Street View to analyse factors such as green spaces, street layout and food outlets in different areas. This information was combined with estimates of individual health behaviours such as physical activity and diet. The researchers also looked at social integration and community support within different neighbourhoods.

Data from nearly 6,000 people living in Paris, Greater London, Ghent, Rotterdam, Amsterdam and Budapest, revealed that levels of physical activity, self-rated health, happiness and neighbourhood preference were associated with how residents perceived and used their neighbourhood.

The presence of food outlets, outdoor recreation facilities, and green spaces varied significantly between the cities. For example, Greater London had the highest proportion of neighbourhoods with a high level of outdoor recreational facilities, while Paris had the highest proportion of neighbourhoods with high urban density and large numbers of food outlets.

Higher levels of social network and social cohesion were associated with better self-rated health, lower odds of obesity and higher fruit consumption, although these social factors were also associated with longer periods spent sitting and less transport-related physical activity.

The researchers also explored why residents of socio-economically deprived areas commonly perceive their neighbourhood as less conducive to healthy behaviours than residents of more affluent areas. Surveys of 5,205 participants provided evidence that neighbourhood perception is not only associated with objective features such as traffic safety and aesthetics, but also with social cohesion.

Research co-author, Ketevan Glonti from the London School of Hygiene & Tropical Medicine, who also co-edited the special journal issue, said: "This research holds an important message for urban planners and policy makers, who have a responsibility to ensure that the neighbourhoods they design and the facilities and businesses within them will promote healthy behaviour such as healthy food purchases and greater physical activity, and protect against unhealthy behaviours. This could save millions of Pounds and Euros in health care costs. The best neighbourhoods are those which have the facilities to support good health and also can encourage social networking and community support."

The research project included a survey of people's descriptions of the boundaries of their residential neighbourhood, since neighbourhood size is thought to be associated to health outcomes. Participants were provided with a map and asked to draw their neighbourhood limits using a web-based tool. Across the five urban areas studied, length of residence was positively associated with the size of self-defined neighbourhoods, suggesting that longer residency was associated with more social activities in the neighbourhood and higher awareness of local facilities. The researchers say this is further evidence that where we live affects our health behaviours and outcomes such as obesity.

The School's Dr Harry Rutter, co-editor of the issue and research co-author, said: "This collection of papers provides a robust evidence base for policy-makers. It provides the latest systematic reviews of the literature along with new survey data and analyses across a range of European urban neighbourhoods. We have known for some years that where a person lives will affect their health, and now we can see more clearly exactly how that happens in practice, and what we need to do about it." 

The SPOTLIGHT project is funded by the European Commission through its Seventh Framework, and comprises multiple European partners including VU University Medical Center (The Netherlands), The European Association for the Study of Obesity, the World Obesity Federation, Ghent University and the University of Paris.

Publications

• H. Bárdos, J. Brug, H. Charreire, S. Compernolle, I. De Bourdeaudhuij, B. Deforche, T. Feuillet, F. Gheysen, K. Glonti, E. Horvath, I. Kawachi, J. Lakerveld, J. van Lenthe, J. D. Mackenbach, M. McKee, L. Mertens, G. Nijpels, J.-M. Oppert, C. Roda, H. Rutter, F. Rutters, P. J. Teixeira, and M. Le Vaillant; February 2016; The SPOTLIGHT Project: Sustainable Prevention of Obesity Through Integrated Strategies in Europe; Special Issue Obesity Reviews, Volume 17, Issue Supplement S1, Pages 5-109; Edited by Harry Rutter and Ketevan Glonti.