Abstract
BACKGROUND: Increasing morbidity and mortality rates of coronary heart disease (CHD) by increasing levels of neighbourhood deprivation may be explained by a positive association between neighbourhood deprivation and risk factors of CHD. In this study we investigated the association between neighbourhood deprivation and overweight. Further, we examined whether this association was modified by educational level, age and sex of the neighbourhood residents.
METHODS: Data were used from 8897 subjects who participated in the baseline measurement of the Dutch GLOBE Study in 1991 and lived in 86 neighbourhoods of the fifth largest city in The Netherlands (Eindhoven). Neighbourhood deprivation was based on aggregated self-reported information about educational and occupational level and employment status. Self-reported body height and body weight were used to define overweight body mass index ((BMI) ≥25).
RESULTS: Adjusted for educational level, age and sex of neighbourhood residents, odds ratios of overweight increased significantly by increasing neighbourhood deprivation (odds ratio=1.20, 95% CI 1.02, 1.41 in the highest vs lowest quartile of neighbourhood deprivation). Stratified analyses showed a stronger association between neighbourhood deprivation and overweight in females compared to males, and in older (≥49 y of age) compared to younger participants. The pattern of increasing odds ratios of overweight by neighbourhood deprivation was generally similar in all educational groups, the highest educational group being the exception with no association between neighbourhood deprivation and overweight.
CONCLUSIONS: Increased prevalence rates of overweight in more compared to less deprived neighbourhoods are likely to contribute to the positive association between neighbourhood deprivation and CHD. Our results justify the development of a community-based strategy of primary prevention of overweight in deprived neighbourhoods, which may have a larger impact in females and older residents in particular. Prior to implementation, however, longitudinal research needs to further examine responsible mechanisms for the development of neighbourhood inequalities in overweight.
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References
Waitzman NJ, Smith KR . Phantom of the area: poverty-area residence and mortality in the United States Am J Public Health 1998 88: 973–976.
Yen I, Kaplan GA . Neighborhood social environment and risk of death: multilevel evidence from the Alameda County Study Am J Epidemiol 1999 149: 898–907.
Bosma H, Mheen H vd, Borsboom GJJM, Mackenbach JP . Neighbourhood socioeconomic status and all-cause mortality Am J Epidemiol 2001 153: 363–371.
Davey-Smith G, Hart C, Watt G, Hole D, Hawthorne V . Individual social class, area-based deprivation, cardiovascular disease risk factors, and mortality: the Renfrew and Paisley Study J Epidemiol Community Health 1998 52: 399–405.
Hart C, Ecob R, Davey-Smith G . People, places and coronary heart disease risk factors: a multi-level analysis of the Scottish Heart Health Study Archive Soc Sci Med 1997 45: 893–902.
Diez-Roux AV, Nieto FJ, Muntaner C, Tyroler HA, Comstock GW, Shalar E, Cooper LS, Watson RL, Szklo M . Neighborhood environments and coronary heart disease: a multilevel analysis Am J Epidemiol 1997 146: 48–63.
Kleinschmidt I, Hills M, Elliott P . Smoking behaviour can be predicted by neighborhood deprivation measures J Epidemiol Community Health 1995 49(Suppl): S72–S77.
Reijneveld SA . The impact of individual and area characteristics on urban socioeconomic differences in health and smoking Int J Epidemiol 1998 27: 33–40.
Yen I, Kaplan GA . Poverty area residence and changes in physical activity level: evidence from the Alameda County Study Am J Public Health 1998 88: 1709–1712.
Seidell JC, Bakx KC, Deurenberg P, Hoogen HJ van den, Hautvast JC, Stijnen T . Overweight and chronic illness—a retrospective cohort study, with a follow-up of 6–17 y in men and women initially 20–50 y of age J Chron Dis 1986 39: 585–593.
Willet WC, Manson JE, Stampfer MJ, Colditz GA, Rosner B, Speizer FE, Hennekens CH . Weight, weight change, and coronary heart disease in women. Risk within the ‘normal’ weight range JAMA 1995 273: 461–465.
Mokdad AH, Serdula MK, Dietz WH, Bowman BA, Marks JS, Koplan JP . The spread of the obesity epidemic in the United States, 1991–1998 JAMA 1999 282: 1519–1522.
Flegal KM, Caroll MD, Kuczmarkski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994 Int J Obes Relat Metab Disord 1998 22: 39–47.
Seidell JC . Time trends in obesity: an epidemiological perspective Horm Metab Res 1997 29: 155–158.
Sobal J, Stunkard AJ . Socioeconomic status and obesity: a review of the literature Psychol Bull 1989 105: 260–275.
Molarius A, Seidell JC, Sans S, Tuomilehto J, Kuulasmaa K . Educational level, relative body weight, and changes in their association over 10 y: an international perspective from the WHO MONICA project Am J Public Health 2000 90: 1260–1268.
Ellaway A, Anderson A, Macintyre S . Does area of residence affect body size and shape Int J Obes Relat Metab Disord 1997 21: 304–308.
Sundquist J, Malmstrom M, Johansson SE . Cardiovascular risk factors and the neighbourhood environment: a multilevel analysis Int J Epidemiol 1999 28: 841–845.
Mackenbach JP, Mheen H van de, Stronks K . A prospective cohort study investigating the explanation of socioeconomic inequalities in health in The Netherlands Soc Sci Med 1994 38: 299–308.
Berkel van-Schaik van AB, Tax B . Towards a standard operationalisation of socio-economic status for epidemiological and socio-medical research Ministerie van WVC: Rijswijk 1990 [in Dutch].
Erikson R, Goldthorpe J, Portocarero L . Intergenerational class mobility and the convergence thesis: England, France and Sweden Br J Sociol 1983 34: 303–342.
Goldstein H . Multilevel statistical models Edward Arnold: London 1995.
Statistical Package for Social Sciences SPSS: Chicago, IL 1987.
Goldstein H, Rasbash J, Plewis I, Draper D, Browne W, Yang M, Woodhouse G, Healy M . A user's guide to MlwiN Multilevel Models Project, Institute of Education, University of London: London 1998.
Nieto-Garcia FJ, Bush TL, Keyl PM . Body mass definitions of obesity: sensitivity and specificity using self-reported weight and height Epidemiology 1990 1: 146–152.
Diez-Roux AV, Nieto FJ, Caulfield L, Tyroler HA, Watson RL, Szklo M . Neighborhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) study J Epidemiol Community Health 1999 53: 55–63.
Sooman A, Macintyre S, Anderson A . Scotland's health-A more difficult challenge for some? The price and availability of healthy foods in socially contrasting localities in the West of Scotland Health Bull 1993 51: 276–284.
Stunkard AJ, Wadden TA . Psychological aspects of human obesity. In: Björntorp P, Brodoff BN (eds) Obesity JP Lippincott: Philadelphia, PA 1992 352–360.
Mann P, Björntorp P . Endocrine-metabolic pattern and adipose tissue distribution Hormone Res 1993 39(Suppl 3): 81–85.
Acknowledgements
The GLOBE Study is carried out by the Department of Public Health of the Erasmus University Rotterdam, in collaboration with the Public Health Services of the city of Eindhoven and the region South-East Brabant. The authors are indebted to Michel Provoost, Ilse Oonk and Roel Faber for constructing the database and the participants for their willingness to participate in the study. The GLOBE Study is supported by grants from the Ministry of Public Health, Welfare and Sport and the Health Research and Development Council (ZON). FvL is supported by a grant from The Netherlands Organization for Scientific Research (NWO grant number 904-66-104).
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van Lenthe, F., Mackenbach, J. Neighbourhood deprivation and overweight: the GLOBE study. Int J Obes 26, 234–240 (2002). https://doi.org/10.1038/sj.ijo.0801841
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DOI: https://doi.org/10.1038/sj.ijo.0801841
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