Since the mid 1980s, the prevalence of obesity among children in the United States has increased dramatically. Currently 18% of children 6-19 years old are considered obese, compared with 6% in the late 1970s. Physical activity is a key determinant of children’s weight as well as an important independent determinant of health.  Researchers have recently started examining the degree to which community-level factors influence children’s physical activity, and in particular, active transportation to and from school. Studies have found that  “walkability” factors such as the density of intersections, lack of dead ends, and tree cover near schools are positive predictors of children walking to school. Another body of literature focuses on the influence of neighborhood safety on levels of physical activity.  Residents of neighborhoods with lower levels of perceived safety have been found to have lower rates of physical activity. Few studies have bridged these literatures and examined the independent contributions of neighborhood safety and walkability on active transportation or physical activity more generally, and none to date have examined these relationships among children.

In the proposed study, we seek to add to this literature by examining two key research questions.  First, we will examine the contributions of walkability measures and perceived neighborhood safety (traffic and crime-related) on active transportation among an ethnically diverse group of low income children.  Little prior research on active transportation has focused on low income children, despite their low rates of active transportation and high levels of obesity.  Second, we will investigate the relationship between children’s active transportation and overall physical activity and obesity.  Prior studies have found active transportation to be highly predictive of overall physical activity for older children and boys, but the relationship has been dependent on age and gender.

The data set that will be used for this research is a cross sectional survey of 765 parents and guardians of children in Florida aged 5-18 who receive Medicaid, the health coverage program for the low income.  The telephone survey was conducted in the fall of 2006 with the primary purpose of providing baseline measures of children’s health-related behaviors prior to implementation of an innovative Medicaid policy that rewards recipients who engage in healthy behaviors.  Respondents answered questions about their child’s active transportation, perceived neighborhood traffic safety and crime levels, and demographics (including child’s height and weight). They also reported their zip code of residence, from which walkability indicators will be developed using Geographic Information System (GIS). Parental report of the child’s height and weight will be used to calculate the body mass index in order to determine whether or not the child is obese. 

Using this data set, we will develop multivariate regression models to identify the independent influences of walkability and safety on active transportation, while controlling for children’s individual characteristics. We will test whether walkability factors are equally important in communities that are perceived to be safe and those that are unsafe.  Then, we will examine the relationship between active transportation and overall physical activity and obesity for this low income population of children.  The findings from this study will add to the emerging body of literature on the influence of community characteristics on active transportation and will uniquely focus on ethnically diverse, low income children.  This study’s findings will provide insight regarding policy approaches that may be effective for encouraging low income, minority children to use active transportation.  Improving physical activity levels for low income children holds great promise for improving health status, and for reducing income and ethnicity-based disparities in health outcomes.