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Introduction: This systematic economic review examined the cost-benefit and cost-effectiveness of park, trail, and greenway infrastructure interventions to increase physical activity or infrastructure use., Methods: The search period covered the date of inception of publications databases through February 2022. Inclusion was limited to studies that reported cost-benefit or cost-effectiveness outcomes and were based in the U.S. and other high-income countries. Analyses were conducted from March 2022 through December 2022. All monetary values reported are in 2021 U.S. dollars., Results: The search yielded 1 study based in the U.S. and 7 based in other high-income countries, with 1 reporting cost-effectiveness and 7 reporting cost-benefit outcomes. The cost-effectiveness study based in the United Kingdom reported $23,254 per disability-adjusted life year averted. The median benefit-to-cost ratio was 3.1 (interquartile interval=2.9-3.9) on the basis of 7 studies., Discussion: The evidence shows that economic benefits exceed the intervention cost of park, trail, and greenway infrastructure. Given large differences in the size of infrastructure, intervention costs and economic benefits varied substantially across studies. There was insufficient number of studies to determine the cost-effectiveness of these interventions., (Published by Elsevier Inc.)

Background: Few studies have examined the underweight-morbidity relationship, and those that have were conducted in non-U.S. populations and limited in their evaluation of cardiovascular disease (CVD) risk factors., Purpose: To examine the associations among underweight (along with overweight and obese) and various CVD risk factors in a national sample of U.S. adults (aged ≥20 years)., Methods: Ten years of data (1999-2010) from the National Health and Nutrition Examination Survey were used (analyzed in 2014). Underweight (tertiles); overweight (25-29.9); and obesity (three classes: 30-34.9, 35-39.9, and ≥40) were assessed from measured BMI. The evaluated biological and anthropometric markers included waist circumference; mean arterial pressure; C-reactive protein (CRP); fasting low-density lipoprotein (LDL) cholesterol; total cholesterol; fasting triglycerides; and fasting glucose., Results: After adjustments, underweight adults had significantly (p<0.005) lower levels of CRP (β=-0.12, Tertile 2); total cholesterol (β=-17.7 and -12.2, Tertiles 1 and 3); total cholesterol to high-density lipoprotein cholesterol ratio (β=-0.39 and -0.46, Tertiles 2 and 3); LDL cholesterol (β=-20.7, Tertile 1); and triglycerides (β=-37.1 and -18.0, Tertiles 1 and 3) compared to normal-weight individuals. The severely underweight and obese were less likely to be physically active than normal-weight adults (p<0.001). Adults in each of the overweight and obese groups had higher levels for each biomarker compared to normal-weight individuals., Conclusions: Underweight adults have lower (i.e., more favorable) levels of various CVD biomarkers., (Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Background: Physical inactivity is more prevalent among racial and ethnic minorities than among Caucasians. It is not known if differences in participation in leisure time physical activity are due to differences in social class. Thus, this paper provides estimates of the prevalence of physical inactivity during leisure time and its relationship to race/ethnicity and social class., Methods: This was a national representative cross-sectional survey with an in-person interview and medical examination. Between 1988 and 1994, 18,885 adults aged 20 or older responded to the household adult and family questionnaires as part of the Third National Health and Nutrition Examination Survey . Mexican-Americans and African-Americans were over-sampled to produce reliable estimates for these groups. Multiple assessment of social class included education, family income, occupation, poverty status, employment status, and marital status., Results: The age-adjusted prevalence (per 100) of adults reporting leisure time inactivity is lower among Caucasians (18%) than among African-Americans (35%) and Mexican-Americans (40%). African-American and Mexican-American men and women reported higher prevalence of leisure time inactivity than their Caucasian counterparts across almost every variable, including education, family income, occupation, employment, poverty and marital status., Conclusions: Current indicators of social class do not seem to explain the higher prevalence of physical inactivity during leisure time among African-American and Mexican-American. More research is needed to examine the effect of other constructs of social class such as acculturation, safety, social support and environmental barriers in promoting successful interventions to increase physical activity in these populations.