Abstrak: Background: Obesity prevalence is higher among those who live in impoverished environments. This investigation identified obesogenic factors in urban neighborhoods surrounding public housing developments (HDs).

Design: Cross-sectional quantitative survey data from 14 HD neighborhoods and qualitative interviews of the HD managers.

Setting: Kansas City, Kansas, and Kansas City, Missouri.

Subjects: Environmental data were collected from HDs and surrounding neighborhoods, an area enclosed by an 800-m radius line drawn from the HD centroid. Qualitative data were collected from all 14 HD managers.

Measures: HDs were rated by a brief environmental audit. HD managers were assessed in a structured 45- to 60-minute interview about neighborhood factors influencing resident obesity.

Results: The properties were typically modern and well maintained; however, there were few physical activity (PA) resources and food sources on site. Most HD managers cited the availability of PA resources near the HD; however, there was wide variability in the type and accessibility of the resources. Only two HDs had a store that sold groceries within one block. Interviews identified fast food restaurants as common food sources, with few other food sources available.

Discussion: Data suggested that although strides have been made to increase safety and comfort in public housing, there remains poor access to PA resources and healthful food sources. Interventions and policies should consider access to PA resources and food sources.

Abstrak: Objectives: I used a semi-parametric analysis of the relationship between body mass index (BMI) and mortality to assess the adequacy of conventional BMI categories for planning public health programs to reduce mortality.

Methods: I linked supplements from the 1987 and 1989 versions of the National Health Interview Survey to the 1995 Multiple Cause of Death File to obtain mortality information. I constructed nonlinear estimates of the association between BMI and mortality using a semiparametric regression technique.

Results: The mortality risk among "normal" weight men (i.e., those in the BMI range of 20 to 25 kg/m(2)) was as high as that among men in the mild obesity category (BMIs of 30-35 kg/m(2)), with a minimum risk observed at a BMI of approximately 26 kg/m(2). Among women, the mortality risk was smallest at approximately 23 to 24 kg/m(2), with the risk increasing steadily with BMIs above 27 kg/m(2). In each specification, the slope of the line was small and volatile through the BMI range of 20 to 35 kg/m(2), suggesting negligible risk differences with minor differences in weight for much of the population.

Conclusions: Traditional BMI categories do not conform well to the complexities of the BMI-mortality relationship. In concurrence with conclusions from previous literature, I found that the current definitions of obesity and overweight are imprecise predictors of mortality risk.