Effects of neighborhood walkability on healthy weight: assessing selection and causal influences

Studies that examine the relationship between neighborhood characteristics and weight are limited because residents are not randomly distributed into neighborhoods. If associations are found between neighborhood characteristics and weight in observational studies, one cannot confidently draw conclusions about causality. We use data from the Utah Population Database (UPDB) that contain body mass index (BMI) information from all drivers holding a Utah driver license to undertake a cross-sectional analysis that compares the neighborhood determinants of BMI for youth and young adults. This analysis assumes that youth have little choice in their residential location while young adults have more choice. Our analysis makes use of data on 53,476 males and 47,069 females living in Salt Lake County in 2000. We find evidence of residential selection among both males and females when BMI is the outcome. The evidence is weaker when the outcomes are overweight or obesity. We conclude that studies that ignore the role of residential selection may be overstating the causal influence of neighborhood features in altering residents’ BMI.