Neighborhood-level socioeconomic deprivation predicts weight gain in a multi-ethnic population: Longitudinal data from the Dallas Heart Study

Abstract

Objective To examine relationship between neighborhood-level socioeconomic deprivation and weight change in a multi-ethnic cohort from Dallas County, Texas and whether behavioral/psychosocial factors attenuate the relationship. Methods Non-movers (those in the same neighborhood throughout the study period) aged 18–65 (N=939) in Dallas Heart Study (DHS) underwent weight measurements between 2000–2009 (median 7-year follow-up). Geocoded home addresses defined block groups; a neighborhood deprivation index (NDI) was created (higher NDI=greater deprivation). Multi-level modeling determined weight change relative to NDI. Model fit improvement was examined with adding physical activity and neighborhood environment perceptions (higher score=more unfavorable perceptions) as covariates. A significant interaction between residence length and NDI was found (p-interaction=0.04); results were stratified by median residence length (11 years). Results Adjusting for age, sex, race/ethnicity, smoking, education/income, those who lived in neighborhood>11 years gained 1.0 kilograms (kg) per one-unit increment of NDI (p=0.03), or 6 kg for those in highest NDI tertile compared with those in the lowest tertile. Physical activity improved model fit; NDI remained associated with weight gain after adjustment for physical activity and neighborhood environment perceptions. There was no significant relationship between NDI and weight change for those in their neighborhood≤11 years. Conclusions Living in more socioeconomically deprived neighborhoods over a longer time period was associated with weight gain in DHS.

Change in Neighborhood Socioeconomic Status and Weight Gain

“…These findings are consistent with longitudinal analyses comparing weight gain among non-movers in the DHS, which linked greater duration of residence in higher-NDI neighborhood to a greater likelihood of weight gain. 17 Changes in biomarkers, including cortisol and c-reactive protein, associated with living in disadvantaged neighborhoods suggest that sympathetic activation or alterations to the typical hypothalamic-pituitary-adrenal axis may contribute to a biological pathway by which exposure to neighborhood deprivation promotes weight gain. 27,28 …”

“…Detailed data collection methods from study entry and follow-up have been previously reported. 16,17 At study entry and follow-up, 3,072 participants completed a detailed survey, anthropometric measures, and laboratory testing. The DHS protocol was approved by University of Texas Southwestern Medical Center’s IRB, and written informed consent was obtained from participants at study entry and follow-up.…”

“…17 As detailed previously, 21 variables from the 2000 U.S. Census were used to develop a Dallas County block group-level neighborhood deprivation index (NDI). 17,21,22 Principal components factor analysis with varimax rotation identified common factors and key variables for the common factor representing neighborhood-level deprivation from the 21 block group variables for the Dallas County NDI. The variables included: % unemployment, % female-headed households, % households on public assistance, % households with a car, % population below the poverty line, and % non-Hispanic blacks.…”

“…NDI was analyzed as a continuous variable, as described elsewhere. 17 Using residential address–derived block group, DHS participants were linked to an NDI value, with higher scores indicating more socioeconomic deprivation.…”

Geospatial and contextual approaches to energy balance and health

“…In addition to diverse cross-sectional analyses, more and more longitudinal analyses (Ewing et al 2006, Powell-Wiley et al 2014), analyses examining respondents who move (Hirsch et al 2014, Knuiman et al 2014), and studies of natural experiments (Fitzhugh et al 2010) are appearing in the health sector. Such studies can strengthen the case that environmental modifications can lead to changes in health behaviours.…”