Older adults living in disadvantaged urban neighborhoods have an increased risk of obesity, a new study has found, possibly due to fear caused by living in areas characterized by crime, disorder and neglect.

“There is almost a twofold higher chance that you’re going to be obese if you live in the worst neighborhoods,” said epidemiologist and lead author Thomas Glass, Ph.D., of Johns Hopkins Bloomberg School of Public Health. “Moreover, the risk is not something that can be explained away by personal variables such as dietary intake, tobacco use and household wealth.”

The study appears in the current issue of the American Journal of Preventive Medicine.

Previous studies of environmental risk factors for obesity have focused primarily on measures of food availability, such as the concentration of fast food restaurants or barriers to physical activity, such as the absence of sidewalks, parks and recreational facilities.

To explore the link between stressors in the environment and excess weight, Glass and colleagues looked at the prevalence of obesity among 1,140 adults, age 50 to 70, residing in one of 65 Baltimore neighborhoods.

The neighborhoods had varying levels of environmental stress as measured by a scale of features that appeared to promote heightened vigilance, fear or alarm.

Fear-inducing factors included visible signs of disorder such as vacant houses and liquor stores, indicators of social disorganization and poverty such as single-parent families and unemployment and public safety measures such as violent crimes and 911 calls.

While the overall obesity rate in this population was 38 percent, it ranged from a low of 27 percent in the least hazardous neighborhoods to a high of 53 percent in the most hazardous neighborhoods.

The explanation for higher obesity rates in the disadvantaged neighborhoods couldn’t be accounted for by simple economics, Glass said, because after accounting for differences in diet and exercise and other individual risk factors, obesity rates were not different between impoverished and more affluent neighborhoods.

According to Kathy Sykes, senior advisor for the Aging Initiative at the Environmental Protection Agency, this study adds to a growing body of research that links the places people live with health outcomes, particularly among older adults.

“While healthy communities are important for people of all ages, we know that this is especially needed for older adults,” Sykes said. “It may be that there are major things going on in our communities that play a bigger role in the obesity problem than simply the fact that people are not eating right and exercising.”

Glass said that the increasing prevalence of obesity in the United States is unlikely to be reversed by individual-level treatment approaches.

“This is an environmental epidemic and it’s going to require environmental solutions,” he said. “Restoring the health of neighborhoods and communities in cities that have gone into disrepair is something that we’re going to have to take more seriously.”

Glass TA, et al. Neighborhoods and obesity in older adults: The Baltimore Memory Study. Am J Prev Med 31(6), 2006.