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The European Journal of Public Health Advance Access originally published online on June 3, 2006
The European Journal of Public Health 2007 17(1):53-61; doi:10.1093/eurpub/ckl073
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© The Author 2006. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

International perspectives

Cross-national comparison of environmental and policy correlates of obesity in Europe

Borsika A. Rabin, Tegan K. Boehmer and Ross C. Brownson

Department of Community Health and Prevention Research Center, School of Public Health Saint Louis University, MO, USA

Correspondence: Borsika A. Rabin, MS, Saint Louis University School of Public Health, 3545 Lafayette Avenue, Salus Center 490A, St Louis, MO 63104, USA; tel: +1 314 977 3287; fax: +1 314 977 3234, e-mail: rabinab{at}slu.edu

Background: Despite the growing agreement that modern environments fuel increased food consumption and decreased physical activity, few studies have addressed environmental and policy correlates of obesity. This study describes obesity patterns across Europe and identifies macroenvironmental factors associated with obesity prevalence at a national level. Methods: Data on obesity prevalence and indicators of the physical, economic, and policy environment were assembled from international databases for 24 European countries. Coefficient estimates between overall, male, and female obesity prevalence and each independent variable were calculated using linear regression. Results: The obesity prevalence varied widely across countries and between genders with higher values in Central and Eastern European countries and lower values in France, Italy, and some Scandinavian countries. Statistically significant inverse associations were observed between overall and female obesity prevalence and variables from the following domains: economic (real domestic product), food (available fat), urbanization (urban population), transport (passenger cars, price of gasoline, motorways), and policy (governance indicators). There was also a negative association between overall obesity and available fruits/vegetables, and between female obesity and single-member households. Male obesity was inversely associated with available fruits/vegetables and density of motorways. The magnitude of the coefficient estimates suggests stronger associations for female obesity than for male obesity in all cases. Conclusions: This exploratory study suggests a need to conduct additional research examining the role of obesogenic environments in European countries, with a special focus on policy-related variables, and to further study gender-specific differences in obesity and its correlates.

Keywords: cross-national comparison, ecological study, environment, Europe, obesity, policy


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