Time lag impacts of rural built environment on obesity: Mediation effects of physical activity

Obesity greatly threatens rural residents’ health and well-being, and addressing it requires urgent optimizations to the built environment (BE). However, few studies have explored the time lag impacts of the BE on obesity, as well as their influential pathways and gender heterogeneity, particularly in the rural context. Based on longitudinal data from China Health and Nutrition Survey (CHNS) between 2004 and 2015, fixed effects models combined with time lag variables were employed to examine the relationship between the BE and body mass index (BMI). Moreover, structural equation models were applied to test the mediation effects of physical activity for transport and exercise in the relationship. Results show that both current and time lag sport places and distance to bus stops are negatively correlated with BMI. Commuting by walking, auto ownership, and durations of exercise are mediators of the BE-BMI relationship. The BE has various associations with the mediators and BMI between women and men. These findings offer new knowledge to the literature and are important to design healthy villages for reducing residents’ risks of being obese.