Spatial accessibility to physical activity facilities and to food outlets and overweight in French youth

Objective: Some characteristics of the built environment have been associated with obesity in youth. Our aim was to determine whether individual and environmental socio-economic characteristics modulate the relation between youth overweight and spatial accessibility to physical activity (PA) facilities and to food outlets. Design: Cross-sectional study. Subjects: 3293 students, aged 12±0.6 years, randomly selected from eastern France middle schools. Measurements and methods: Using geographical information systems (GIS), spatial accessibility to PA facilities (urban and nature) was assessed using the distance to PA facilities at the municipality level; spatial accessibility to food outlets (general food outlets, bakeries and fast-food outlets) was calculated at individual level using the student home address and the food outlets addresses. Relations of weight status with spatial accessibility to PA facilities and to food outlets were analysed using mixed logistic models, testing potential direct and interaction effects of individual and environmental socio-economic characteristics. Results: Individual socio-economic status modulated the relation between spatial accessibility to PA facilities and to general food outlets and overweight. The likelihood of being overweight was higher when spatial accessibility to urban PA facilities and to general food outlets was low, but in children of blue-collar-workers only. The odds ratio (OR) (95% confidence interval) for being overweight of blue-collar-workers children compared with non-blue-collar-workers children was 1.76 (1.25–2.49) when spatial accessibility to urban PA facilities was low. This OR was 1.86 (1.20–2.86) when spatial accessibility to general food outlets was low. There was no significant relationship of overweight with either nature PA facilities or other food outlets (bakeries and fast-food outlets). Conclusion: These results indicate that disparities in spatial accessibility to PA facilities and to general food outlets may amplify the risk of overweight in socio-economically disadvantaged youth. These data should be relevant for influencing health policies and urban planning at both a national and local level.