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International Journal of Health Geographics

, 15:35

First Online: 04 October 2016Received: 31 May 2016Accepted: 28 September 2016DOI: 10.1186-s12942-016-0065-5

Cite this article as: Cebrecos, A., Díez, J., Gullón, P. et al. Int J Health Geogr 2016 15: 35. doi:10.1186-s12942-016-0065-5


BackgroundHealthier urban environments influence the distribution of cardiovascular risk factors. Our aim was to design and implement a multicomponent method based on Geographic Information Systems to characterize and evaluate environmental correlates of obesity: the food and the physical activity urban environments.

MethodsStudy location comprised a socio-demographically average urban area of 12 contiguous census sections ≈16,000 residents, in Madrid, Spain. We conducted on-field audits on all food stores and street segments. We designed a synthetic index integrating continuous measures of both environments, by kernel density analyses. Index ranges from 0 to 100 least-most healthy.

ResultsWe found a heterogeneous distribution with 75 and 50 % of the area scoring less than 36.8 and 25.5, respectively. Census sections of study area were categorized by Jenks intervals as high, medium–high, medium–low and low. 41.0 % of residents lived in an area with a low score, 23.6 % medium–low and 31.1 % medium–high and 4.2 % in a high.

ConclusionThe proposed synthetic index may be a relevant tool to inform urban health interventions, providing a feasible way to integrate different measures of barriers and facilitators of healthy urban environments in terms of food and physical activity.

KeywordsSynthetic index Geographic Information Systems Healthy food availability Physical activity Obesogenic environments AbbreviationsGISGeographic Information System

MNIMedian Neighborhood Index

NEMS-SNutrition Environment Measures Survey in Stores

HFAIHealthy Food Availability Index

M-SPACESMadrid Systematic Pedestrian and Cycling Environment Scan

KDEkernel density estimation

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Autor: Alba Cebrecos - Julia Díez - Pedro Gullón - Usama Bilal - Manuel Franco - Francisco Escobar


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