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Impact of built, social, and economic environments on adolescent obesity and related health behaviors

APA Citation:

Prados, M. J., Nicosia, N., & Datar, A. (2023). Impact of built, social, and economic environments on adolescent obesity and related health behaviors. Obesity, 31(4), 1085–1094. https://doi.org/10.1002/oby.23682

Abstract Created by REACH:

This study investigated the impact of county-level, contextual influences on military-connected adolescents’ physical health outcomes such as body mass index (BMI). Specifically, adolescents’ built environment (e.g., access to fast food restaurants, recreational facilities), social environment (e.g., graduation rate, crime rate), and economic environment (e.g., median household income, unemployment rate) were examined. 1,111 adolescents with an active-duty parent selfreported their height and weight (used to calculate BMI and obese or overweight status), diet, and physical activity. Information on built, social, and economic environments was gathered via community surveys and county health rankings. Analyses were conducted using the full sample and 2 subsamples: participants who lived on a military installation for 2+ years (n = 682), and those who lived off-installation (n = 604). Overall, the built environment, but not the social or economic environments, was related to adolescent health outcomes.


Physical health
Mental health

Branch of Service:

Multiple branches

Military Affiliation:

Active Duty

Subject Affiliation:

Child of a service member or veteran


Childhood (birth - 12 yrs)
Adolescence (13 - 17 yrs)


Prados, María J., Nicosia, Nancy, Datar, Ashlesha


Objective This study aimed to estimate the effects of the built, social, and economic environments on adolescent obesity and related behaviors. Methods Exploiting quasi-exogenous variation in military families' geographic location, this study estimated intent-to-treat models of the association between the assigned installation's county environments and adolescents' (mean age 13.5 years) self-reported and model-corrected BMI, overweight or obesity status, and self-reported diet and exercise. Three indices for the built, social, and economic environments characterized county-level environments (higher value implies more advantageous environments) based on 19 indicators. Multivariate linear and logistic models were estimated on the full sample (N = 1111) and on subsamples with greater exposure based on time (n = 682) and off-installation residence (n = 604). Results Exposure to more advantageous built environments for more than 2 years was associated with lower probabilities of obesity (−0.18; 95% CI: −0.34 to −0.026) and overweight or obesity (−0.34; 95% CI: −0.56 to −0.12) and was associated with lower BMI z scores (−0.76; 95% CI: −1.45 to −0.02). Results for adolescents living off-installation were similar. More advantageous built environments were also associated with lower consumption of unhealthy foods, but not with physical activity. Social and economic environments were not associated with any outcomes. Conclusions The built environment, but not social and economic environments, was a strong predictor of adolescents' BMI, overweight or obesity status, and eating behaviors.

Publication Type:

REACH Publication


adolescent obesity, BMI, obesity status, eating behavior

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REACH Publication Type:

Research Summary

REACH Newsletter:

  September 2023

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