TY - JOUR
T1 - The association between adverse childhood experiences, neighborhood greenspace, and body mass index
T2 - A cross-sectional study
AU - Schroeder, Krista
AU - Forke, Christine M.
AU - Noll, Jennie G.
AU - Wheeler, David C.
AU - Henry, Kevin A.
AU - Sarwer, David B.
N1 - Funding Information:
The authors would like to acknowledge Gary Klein, who provided insight regarding analytic approaches for the Philadelphia ACE Survey data. Philadelphia ACE Survey data were used with permission from the Health Federation of Philadelphia and the Philadelphia ACE Task Force Research & Data Committee. Health data were provided by Public Health Management Corporation's (PHMC) Center for Data Innovation, Southeastern Pennsylvania Household Health Survey, 2012. This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD101554 PI: Schroeder) and (P50 HD089922; PI: Noll) of the National Institutes of Health. Dr. Sarwer's work was supported by grant funding from the National Institutes of Health (National Institute for Diabetes, Digestive, and Kidney Disease R01 DK108628 and National Institute of Dental and Craniofacial Research R01 DE026603). The Philadelphia ACE Survey was funded by the Robert Wood Johnson Foundation and was supported by the Thomas Scattergood Behavioral Health Foundation and the Stoneleigh Foundation. The content is solely the responsibility of the authors and does not necessarily represent the views of the funders. The funders had no role in study design; collection, analysis, and interpretation of data; writing the report; nor the decision to submit the report for publication.
Funding Information:
This research was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23 HD101554 PI: Schroeder) and (P50 HD089922; PI: Noll) of the National Institutes of Health. Dr. Sarwer’s work was supported by grant funding from the National Institutes of Health (National Institute for Diabetes, Digestive, and Kidney Disease R01 DK108628 and National Institute of Dental and Craniofacial Research R01 DE026603). The Philadelphia ACE Survey was funded by the Robert Wood Johnson Foundation and was supported by the Thomas Scattergood Behavioral Health Foundation and the Stoneleigh Foundation. The content is solely the responsibility of the authors and does not necessarily represent the views of the funders. The funders had no role in study design; collection, analysis, and interpretation of data; writing the report; nor the decision to submit the report for publication.
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/10
Y1 - 2022/10
N2 - An association between adverse childhood experiences (ACEs) and elevated body mass index (BMI) has been found in previous investigations. ACEs’ effects on BMI have been primarily considered via individual-level physiological and behavioral frameworks. Neighborhood factors, such as greenspace, are also associated with BMI and may merit consideration in studies examining ACEs-BMI associations. This exploratory study examined associations of BMI with ACEs and neighborhood greenspace and tested whether greenspace moderated ACEs-BMI associations. Methods entailed secondary analysis of cross-sectional data. ACEs and BMI were captured from 2012/2013 Philadelphia ACE Survey and 2012 Southeastern Household Heath Survey data; greenspace percentage in participants’ (n = 1,679 adults) home neighborhoods was calculated using National Land Cover Database data. Multi-level, multivariable linear regression 1) examined associations between BMI, ACEs, (0 ACEs [reference], 1–3 ACEs, 4 + ACEs), and neighborhood greenspace levels (high [reference], medium, low) and 2) tested whether greenspace moderated the ACEs-BMI association (assessed via additive interaction) before and after controlling for sociodemographic and health-related covariates. Experiencing 4 + ACEs (β = 1.21; 95 %CI: 0.26, 2.15; p = 0.01), low neighborhood greenspace (β = 1.51; 95 %CI: 0.67, 2.35; p < 0.01), and medium neighborhood greenspace (β = 1.37; 95 %CI: 0.52, 2.21; p < 0.01) were associated with BMI in unadjusted models. Only low neighborhood greenspace was associated with BMI (β = 0.95; 95 %CI: 0.14, 1.75; p = 0.02) in covariate-adjusted models. The ACEs-greenspace interaction was not significant in unadjusted (p = 0.89–0.99) or covariate-adjusted (p = 0.46–0.79) models. In conclusion, when considered simultaneously, low neighborhood greenspace, but not ACEs, was associated with BMI among urban-dwelling adults in covariate-adjusted models.
AB - An association between adverse childhood experiences (ACEs) and elevated body mass index (BMI) has been found in previous investigations. ACEs’ effects on BMI have been primarily considered via individual-level physiological and behavioral frameworks. Neighborhood factors, such as greenspace, are also associated with BMI and may merit consideration in studies examining ACEs-BMI associations. This exploratory study examined associations of BMI with ACEs and neighborhood greenspace and tested whether greenspace moderated ACEs-BMI associations. Methods entailed secondary analysis of cross-sectional data. ACEs and BMI were captured from 2012/2013 Philadelphia ACE Survey and 2012 Southeastern Household Heath Survey data; greenspace percentage in participants’ (n = 1,679 adults) home neighborhoods was calculated using National Land Cover Database data. Multi-level, multivariable linear regression 1) examined associations between BMI, ACEs, (0 ACEs [reference], 1–3 ACEs, 4 + ACEs), and neighborhood greenspace levels (high [reference], medium, low) and 2) tested whether greenspace moderated the ACEs-BMI association (assessed via additive interaction) before and after controlling for sociodemographic and health-related covariates. Experiencing 4 + ACEs (β = 1.21; 95 %CI: 0.26, 2.15; p = 0.01), low neighborhood greenspace (β = 1.51; 95 %CI: 0.67, 2.35; p < 0.01), and medium neighborhood greenspace (β = 1.37; 95 %CI: 0.52, 2.21; p < 0.01) were associated with BMI in unadjusted models. Only low neighborhood greenspace was associated with BMI (β = 0.95; 95 %CI: 0.14, 1.75; p = 0.02) in covariate-adjusted models. The ACEs-greenspace interaction was not significant in unadjusted (p = 0.89–0.99) or covariate-adjusted (p = 0.46–0.79) models. In conclusion, when considered simultaneously, low neighborhood greenspace, but not ACEs, was associated with BMI among urban-dwelling adults in covariate-adjusted models.
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U2 - 10.1016/j.pmedr.2022.101915
DO - 10.1016/j.pmedr.2022.101915
M3 - Article
C2 - 35911582
AN - SCOPUS:85134839959
SN - 2211-3355
VL - 29
JO - Preventive Medicine Reports
JF - Preventive Medicine Reports
M1 - 101915
ER -