Degree

Doctor of Philosophy (PhD)

Department

The Department of Geography and Anthropology

Document Type

Dissertation

Abstract

There has been an increasing body of research on the relation between obesogenic environment and health, but far less focused on child health. This study sets its sight on the health disparity of 5-11 years old children enrolled in Medicaid in Louisiana and examines how it is related to the built environment factors including food outlets and physical activity facilities. Specifically, (1) the food environment is defined as spatial accessibility of healthy vs. unhealthy restaurants and grocery stores based on the ZIP Codes Business Patterns (ZBP) data coded in the North American Industry Classification System (NAICS); and the physical activity environment includes (2) walkability based on the National Walkability Index (NWI) from the U.S. Environmental Protection Agency (EPA), and (3) spatial accessibility of playgrounds, parks and other recreational facilities. Children’s health information including demographics and diagnosis is extracted from the Louisiana Healthcare Connection (LHCC). Health outcome variable is clinical diagnosis of obesity. On the methodology front, spatial accessibility of food outlets and physical activities are implemented in Geographic Information Systems (GIS) automated tools, and a multilevel modeling (MLM) approach is employed to examine the joint effects of social determinants of health (SDOH) factors measured at the individual level as well as the ZIP code area and county levels. The research identifies high-risk populations and geographic areas that would benefit most from public health prevention and treatment services.

Date

7-14-2025

Committee Chair

Fahui Wang

DOI

10.31390/gradschool_dissertations.6829

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Available for download on Wednesday, July 14, 2032

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