Pathways through which higher neighborhood crime is longitudinally associated with greater body mass index

BACKGROUND Although crime and perceived safety are associated with obesity and body mass index (BMI), the pathways are less clear. Two likely pathways by which crime and perceived safety may impact obesity are through distress and physical activity. METHODS We examined data from 2013 to 2014 for 644 predominantly African-American adults (mean age 57 years; 77% female) living in low-income Pittsburgh, PA neighborhoods, including self-reported perceptions of safety and emotional distress, interviewer-measured height/weight, and physical activity measured via accelerometry. We used secondary data on neighborhood crime from 2011 to 2013. We built a structural equation model to examine the longitudinal direct and indirect pathways from crime to BMI through perceived safety, distress and physical activity. RESULTS Long-term exposure to crime was positively associated with lack of perceived safety (β = 0.11, p = 0.005) and lack of perceived safety was positively associated with BMI (β = 0.08, p = 0.03). The beneficial association between physical activity and BMI (β = -0.15, p < 0.001) was attenuated by a negative association between crime and physical activity (β = -0.09, p = 0.01). Although crime was associated with distress we found no evidence of a path from crime to BMI via distress. CONCLUSIONS Our findings suggest decrements in perceived safety and physical activity are important processes that might explain why neighborhood crime is associated with greater BMI.