Change in Neighborhood Socioeconomic Status and Weight Gain

Abstract

Introduction Despite a proposed connection between neighborhood environment and obesity, few longitudinal studies have examined the relationship between change in neighborhood socioeconomic deprivation, as defined by moving between neighborhoods, and change in body weight. The purpose of this study is to examine the longitudinal relationship between moving to more socioeconomically deprived neighborhoods and weight gain as a cardiovascular risk factor. Methods Weight (kg) was measured in the Dallas Heart Study (DHS), a multiethnic cohort aged 18–65 years, at baseline (2000–2002) and 7-year follow-up (2007–2009, N=1,835). Data were analyzed in 2013–2014. Geocoded addresses were linked to Dallas County, TX census block groups. A block group-level neighborhood deprivation index (NDI) was created. Multilevel difference-in-difference models with random effects and a Heckman correction factor (HCF) determined weight change relative to NDI change. Results Forty-nine percent of the DHS population moved (263 to higher NDI, 586 to lower NDI, 47 within same NDI), with blacks more likely to move than whites or Hispanics (p<0.01), but similar baseline BMI and waist circumference were observed in movers vs. non-movers (p>0.05). Adjusting for HCF, sex, race, and time-varying covariates, those who moved to areas of higher NDI gained more weight compared to those remaining in the same or moving to a lower NDI (0.64 kg per 1-unit NDI increase, 95% CI=0.09, 1.19). Impact of NDI change on weight gain increased with time (p=0.03). Conclusions Moving to more–socioeconomically deprived neighborhoods was associated with weight gain among DHS participants.

A novel approach for measuring residential socioeconomic factors associated with cardiovascular and metabolic health

“…5–14,17 However, this does not support our findings for cluster 6. Cluster 6 had a low percentage of people living below the poverty line, unemployed, and Black.…”

“…Seven categories (education, wealth, income, race, employment, housing, and land-use), defined by 12 variables from the Census (Table 1) and cited in previous work on neighborhood-level SES and health, were identified as being influential. 6,7,11,12,14,21,25,32,33 These variables were chosen without previous knowledge of their distribution across our study area, and no variables were excluded in a sensitivity analysis to try to determine the most influential attributes or bias the results.…”

“…In these studies, neighborhood SES was associated with cardiovascular-related mortality, 5,6 stroke, 7,8 coronary heart disease, 9,10 and myocardial infarction, 11 and in lower income neighborhoods associations between neighborhood SES and metabolic-related health effects were also observed. 12–14 Studies have identified two major mediators of these effects: psychosocial stress 2,15,16 and limited access to resources. 17–20 These factors can put communities at an increased risk for poor health by influencing mental wellbeing, diet, and physical activity.…”

“…With respect to statistical methods, the most commonly employed methods are the construction of a neighborhood deprivation index (NDI) or z -score. 6,8,14,23–25 Some of the published indices which measure neighborhood deprivation use principal component analysis (PCA) as a data reduction technique to find non-correlated linear combinations with maximum variance. From this, components are used to weigh the variable contributions.…”

Socioeconomic modifiers of genetic and environmental influences on body mass index in adult twins.

“…Neighborhood deprivation, consistently associated with mortality (Pearson, Apparicio, & Riva, 2013; Ross, Oliver, & Villeneuve, 2013), is one such factor. Research has consistently found effects of neighborhood deprivation on BMI (El-Sayed, Scarborough, & Galea, 2012; Matheson, Moineddin, & Glazier, 2008; Powell-Wiley et al, 2015), And neighborhood SES has also been associated with obesity risk (Black & Macinko, 2008; El-Sayed et al, 2012; Glass, Rasmussen, & Schwartz, 2006). Macro-level social factors such as neighborhood-level socioeconomic deprivation are becoming increasingly relevant to research investigating environmental determinants of health.…”