Читать книгу Clinical Obesity in Adults and Children - Группа авторов - Страница 41

The association between crime levels, obesity, and weight‐related behaviors (e.g. physical activity and diet) has been widely explored [83]. Lack of safety in urban areas may be an important pathway by which physical activity decreases among both adults and children and particularly among women and girls [84]. High levels of perceived or objective crime may make residents reluctant to use neighborhood amenities even if they are available [85]. For example, one study in Nigeria of approximately 2000 randomly selected urban residents found that feeling unsafe from crime or traffic was associated with overweight even after adjusting for neighborhood sociodemographic variables [86]. Similar associations have been reported in high‐income countries. For example, low criminality is associated with lower BMI and obesity prevalence among women in Spain [87]. A study conducted on almost 15,000 patients recruited from primary care clinics in Chicago has shown that recurrent exposure to high rates of violent crime was associated with obesity [88]. Similarly, studies in the United States have shown lower rates of physical activity and higher rates of obesity among children living in unsafe neighborhoods [89,90]. This association is particularly relevant for ethnic minorities who may be more likely to live in neighborhoods with higher crime rates [91–93]. A study in the US state of Indiana found that access to walking trails is associated with lower childhood obesity in low‐crime neighborhoods but not in high‐crime neighborhoods [90]. These findings highlight the need for multisectoral action to prevent obesity. Without addressing high violent crime rates, physical activity promotion interventions are unlikely to be effective.