Neighbourhood food, physical activity, and educational environments and black/white disparities in obesity: a complex systems simulation analysis
Authored by Sandro Galea, Mark G Orr, George A Kaplan
Date Published: 2016
DOI: 10.1136/jech-2015-205621
Sponsors:
Robert Wood Johnson Foundation
United States National Institutes of Health (NIH)
Platforms:
No platforms listed
Model Documentation:
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Abstract
Background Multiple approaches that can contribute to reducing obesity
have been proposed. These policies may share overlapping pathways, and
may have unanticipated consequences, creating considerable complexity.
Aiming to illuminate the use of agent-based models to explore the
consequences of key policies, this paper simulates the effects of
increasing neighbourhood availability of good food stores, physical
activity infrastructure and higher school quality on the reduction of
black/white disparities in body mass index (BMI) in the USA.
Methods We used an agent-based model, with parameters derived from the
empirical literature, which included individual and neighbourhood
characteristics over the life course as determinants of behaviours
thought to impact BMI. We systematically varied the strength of the 3
policy interventions, examining the impact of 125 different policy
scenarios on black/white BMI disparities.
Results In the absence of any of these policies, black/white BMI
disparities generally increased over time. However, we found that some
combinations of these policies resulted in reductions in BMI, yielding
decreases in the black/white BMI disparity as large as a 90\%.
Conclusions Within the structure of relationships captured in this
simulation model, there is support for the further use of agent-based
simulation models to explore upstream policies as plausible candidates
for the reduction of black/white disparities in BMI. These results
highlight the potential insights into important public health problems, such as obesity, that can come from uniting the systems science approach
with policy analysis.
Tags
Adults
School quality