Estimating the effect of mobility and food choice on obesity in a rural, northern environment

- We model obesity using a social-ecological approach.
- Accounting for the endogeneity of food choice and mobility influences estimates compared to an exogenous specification.
- We estimate overweight/obese probabilities using a structural equation model.
- Both longer term and short term modifiable risk factors can inform obesity prevention strategies.

The literature suggests that energy balance is shaped by where food is accessed, mobility behaviors, beliefs, preferences, socioeconomic characteristics, and attributes of the built environment. However, the relationship of these factors with energy balance has not been simultaneously considered on a regional scale. Utilizing a social-ecological framework, this study incorporated individual level and geospatial data to estimate a structural equation model (SEM) to examine the complex association of these variables with being overweight or obese. Results indicate that food choice, mobility, demographic characteristics, and normative beliefs are related to energy imbalance. Further, accounting for the endogeneity of food access and mobility changes both the significance and magnitude of factors associated with obesity as compared to treating them as exogenous.