Residential Environment and Health: A Review of Methodological and Conceptual Issues

Abstract

Geographic patterns of poor health and mortality risk are found in most countries. Important health effects at the neighborhood level are mortality, general health, illness and disabilities, mental health, and healthcare utilization. Awareness of the influence of social class on health has been growing during the last decades. Studies show that individuals with lower socioeconomic status (SES) have a shorter life expectancy than do their 'well-off' counterparts. Yet SES-related health inequalities cannot be fully explained by individual characteristics, and environmental qualities should be taken into account. Many aspects of local areas that might be related to health or access to opportunities to live healthily are systematically poorer in socially disadvantaged areas. Such factors have the potential to explain health differences between deprived and prosperous neighborhoods. Investigating health differences at the neighborhood level implies conceptual as well as methodological issues pertaining to selection, accumulation, multiple level measurement, objective features versus perceptions, and time dynamic aspects. This article reviews such issues and evaluates several exemplary theoretical approaches from the fields of public health and environmental health in their ability to overcome such problems.

Decomposing the rural-urban disparities in overweight and obesity among women of reproductive age in Nigeria

“…Similarly, our study shows in the unadjusted logistic regression analysis that the risk of being overweight and obese is twice as high among women who are employed compared to unemployed women. These findings corroborate findings from previous studies on overweight and obesity in Nigeria [ 18 , 36 ]. In most developing nations, household wealth is a predictor of overweight and obesity.…”

“…We discovered in our logistic regression analysis that women who live in rural areas have a lower risk of being overweight/obese, which is in line with previous studies in Nigeria [ 18 , 36 , 45 ]. These inequalities between the urban and rural areas in Nigeria may be explained by variances in urban people’s lifestyles, nutritional habits, technological advancements, and more prevalence of vehicles that limit mobility exercises.…”

“…The relationship between wealthy households and overweight/obesity can be attributed to having sedentary lifestyles and various diets that are high in energy [ 36 ]. On the other hand, women belonging to poor households are more prone to malnutrition, caused by poor food intake such as protein-energy malnutrition, vitamin deficiencies, and diet-related, which may lead to being underweight [ 18 ]. Another plausible explanation is that women from wealthy households are more likely to have high incomes to afford diets rich in saturated fats.…”

“…The influence of residential location on health outcomes is profoundly significant. Urban areas, characterized by a high concentration of fast-food establishments, convenience stores, and modern technologies facilitating the availability of processed foods, contribute to an environment conducive to poor health [ 18 , 36 ]. The sedentary lifestyle prevalent in urban settings, resulting from limited opportunities for physical activity due to crowded living conditions and a scarcity of open spaces, further exacerbates the issue [ 12 ].…”

“…The prevalence of obesity in urban areas is significantly higher, reaching 16.5%, whereas rural areas report a lower prevalence of 4.0% [ 8 ]. Overweight and obesity are complex conditions influenced by multiple factors, including dietary habits [ 9 – 11 ], physical activity and lifestyle [ 12 , 13 ], genetics [ 14 ], psychological factors [ 15 , 16 ], environmental factors [ 17 , 18 ], and medical conditions such as hormonal imbalances [ 9 ].…”