Deprivation matters: understanding associations between neighbourhood deprivation, unhealthy food outlets, unhealthy dietary behaviours and child body size using structural equation modelling

Abstract

Background Children residing in neighbourhoods of high deprivation are more likely to have poorer health, including excess body size. While the availability of unhealthy food outlets are increasingly considered important for excess child body size, less is known about how neighbourhood deprivation, unhealthy food outlets and unhealthy dietary behaviours are interlinked. Methods This study involves children aged 8-13 years (n=1029) and resided in Auckland, New Zealand. Unhealthy dietary behaviours (frequency of consumption of unhealthy snacks and drinks) and food purchasing behaviour on the route to and from school were self-reported. Height and waist circumference were measured to calculate waist-toheight ratio (WtHR). Geographic Information Systems mapped neighbourhood deprivation and unhealthy food outlets within individual, child-specific neighbourhood buffer boundaries (800 m around the home and school). Associations between neighbourhood deprivation (calculated using the New Zealand Index of Deprivation 2013), unhealthy food outlets, unhealthy dietary behaviours and WtHR were investigated using structural equation modelling in Mplus V.8.0. Age, sex and ethnicity were included as covariates, and clustering was accounted for at the school level. Results Structural equation models showed that unhealthy food outlets were unrelated to unhealthy dietary behaviours (estimate 0.029, p=0.416) and excess body size (estimate −0.038, p=0.400). However, greater neighbourhood deprivation and poorer dietary behaviours (estimate −0.134, p=0.001) were associated with greater WtHR (estimate 0.169, p<0.001). Conclusion Excess child body size is associated with neighbourhood deprivation and unhealthy dietary behaviours but not unhealthy outlet density or location of these outlets near home and school. 460 Egli V, et al.

The Importance of Pedestrian Network Connectivity for Adolescent Health: A Cross-sectional Examination of Associations between Neighbourhood Built Environments and Metabolic Health in the Pacific Islands Families Birth Cohort Study

“…It is likely the neighbourhood nutrition environment may relate to both nutrition behaviours and metabolic health [32,59]. Increased access to suboptimal nutrition environments (e.g., through increased pedestrian connectivity) may encourage unhealthy nutrition behaviours, ultimately leading to increased metabolic risk [60]. On the other hand, greater FFM can exist in the presence of other metabolic risk factors.…”

Associations between Neighborhood Deprivation Index, Parent Perceptions and Preschooler Lifestyle Behaviors

“…A further study from New Zealand investigated the association between neighborhood deprivation, unhealthy food outlets, unhealthy dietary behaviors, and children's weight status. The authors concluded that the neighborhood availability of unhealthy food outlets was not associated with children's weight status; however, high deprivation index and unhealthy dietary intake were positively associated with higher body weight in children [22].…”

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“…Understanding the individual aspects of the neighborhood environment associated with the diet and physical activity/sedentary behaviors of children could have significant positive health effects from a public health perspective. Increased knowledge of the influence of the neighborhood deprivation index, which has demonstrated strong correlations with a range of health and social outcomes measures [22,25,26], and parental perceptions of their local neighborhood on pre-school children's dietary intakes, physical activity, and screen time behaviors can inform the creation of a healthy environment for this age group [27]. Therefore, the aim of this study was to examine the neighborhood deprivation index and to investigate whether parental perceptions of their neighborhood environment were associated with their pre-school children's physical activity, TV screen time, and healthy/unhealthy markers of dietary intake.…”

Improving spatial data in health geographics: a practical approach for testing data to measure children’s physical activity and food environments using Google Street View

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