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Environmental phenotypes for healthy weight in children using population-based linked environment and health data: a cross-sectional observational study

Jo Davies, Rowena Bailey, Rebecca Pedrick-Case Orcid Logo, Gareth Stratton, Dora Pouliou Orcid Logo, Amy Mizen Orcid Logo, Hayley Christian, Bryan Boruff, Ronan Lyons, Rich Fry Orcid Logo, Lucy Griffiths Orcid Logo

Health & Place, Volume: 100, Start page: 103681

Swansea University Authors: Jo Davies, Rowena Bailey, Rebecca Pedrick-Case Orcid Logo, Gareth Stratton, Dora Pouliou Orcid Logo, Amy Mizen Orcid Logo, Ronan Lyons, Rich Fry Orcid Logo, Lucy Griffiths Orcid Logo

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Abstract

Childhood obesity is a major global health challenge, projected to affect one in three children worldwide by 2050. While individual and social factors contribute, increasing evidence highlights the built environment as a key determinant in shaping children's behaviours and weight outcomes. Evid...

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Published in: Health & Place
ISSN: 1873-2054
Published: Elsevier BV 2026
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa72109
Abstract: Childhood obesity is a major global health challenge, projected to affect one in three children worldwide by 2050. While individual and social factors contribute, increasing evidence highlights the built environment as a key determinant in shaping children's behaviours and weight outcomes. Evidence suggests that neighbourhood design, greenspace access, and food retail availability influence diet and physical activity, but most studies rely on small samples or single-domain measures. We linked nationwide geographic information systems (GIS) data describing residential neighbourhoods with objectively measured child weight from a national Welsh surveillance programme for children aged 4-5 years. Using multiple indicators-including housing type, garden size, neighbourhood greenness, walkability, access to recreational spaces, and food outlet density - latent class analysis was used to identify distinct "environmental phenotypes." Associations between phenotypes and child weight status were examined using logistic regression. We identified discrete classes of residential environments characterised by varying combinations of built and food environment features. The model with five classes was the best fit overall, with percentage and number of households in each phenotypes: Rural, spacious and isolated 14% (24,266), Suburban 17% (29,324), Deprived and underserved 23% (39,227), Deprived and well-served 32% (53,210), and Dense, coastal and well-connected 13% (21,762). Children living in rural, spacious and isolated neighbourhoods, characterised as those with greater greenspace, private gardens, and walkable layouts, had significantly lower odds of overweight and obesity (OR = 0.89, CI = 0.86-0.93), whereas those in deprived and well-served neighbourhoods, characterised by high-density housing areas with limited greenspace and high fast-food outlet density, had elevated risk (OR = 1.09, CI = 1.06-1.13). These associations remained robust after adjustment for area-level deprivation and rurality. Our findings highlight the importance of the residential environment in early childhood obesity risk. Nationally linked GIS and health data enable robust classification of obesogenic environments, informing urban planning and public health strategies to promote healthier, child-friendly neighbourhoods.
College: Faculty of Medicine, Health and Life Sciences
Funders: This work is part of the Built Environment and Child Health in Wales and Australia (BEACHES) project which is a joint initiative between Telethon Kids Institute, University of Western Australia and Swansea University. The BEACHES Project is funded by the UKRI-NHMRC Built Environment Prevention Research Scheme (grant number GNT1192764 and MR/T039329/1). Administrative Data Research (ADR) Wales also supported this research, which forms part of the ADR UK investment that unites research expertise from Swansea University Medical School and WISERD (Wales Institute of Social and Economic Research and Data) at Cardiff University with analysts from Welsh Government. ADR UK is funded by the Economic and Social Research Council (ESRC), part of UK Research and Innovation. Hayley Christian is supported by an Australian National Heart Foundation Future Leader Fellowship (102549) and partially supported by the Australian Government through the Australian Research Council's Centre of Excellence for Children and Families over the Life Course (Project ID CE200100025).
Start Page: 103681