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Selvakumaran S, Lin CY, Hadgraft N, Chandrabose M, Owen N, Sugiyama T. Area-level socioeconomic inequalities in overweight and obesity: Systematic review on moderation by built-environment attributes. Health Place 2023; 83:103101. [PMID: 37625238 DOI: 10.1016/j.healthplace.2023.103101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 08/03/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
Residents of lower socioeconomic status (SES) areas are at a higher risk of overweight/obesity than those from higher SES areas. Built environment attributes may mitigate such inequalities. This systematic review synthesised findings of studies examining built environment attributes as potential moderators of the associations between area-level SES and overweight/obesity in adults. From five databases, nine eligible studies were identified. The SES-overweight/obesity relationship was stronger in inner areas and suburbs of large cities, while it was weaker in more rural areas. Two studies examined walkability and reported contrasting findings: no moderation in one and marginally significant moderation (less inequality in higher walkability areas) in the other. No evidence of moderation was found for street connectivity, population density, the food environment, access to physical activity facilities and several perceived environmental attributes. Further research is needed on other built environment attributes (e.g., access to, quantity and quality of green spaces, active transport features), and ideally using prospective study designs and objective makers of adiposity.
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Affiliation(s)
- Sungkavi Selvakumaran
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia.
| | - Chien-Yu Lin
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Department of Public Health, College of Public Health, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist., Taichung, 406040, Taiwan; Faculty of Sport Sciences, Waseda University, 2-579-15 Mikajima, Tokorozawa City, Saitama, 359-1192, Japan.
| | - Nyssa Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Manoj Chandrabose
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Neville Owen
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
| | - Takemi Sugiyama
- Centre for Urban Transitions, Swinburne University of Technology, Level 1 EW Building, Hawthorn, VIC, 3122, Australia; Baker Heart & Diabetes Institute, 75 Commercial Rd, Melbourne, VIC, 3004, Australia.
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Coppell KJ, Keall M, Mandic S. Dietary Pattern Indicators among Healthy and Unhealthy Weight Adolescents Residing in Different Contexts across the Otago Region, New Zealand. Children (Basel) 2023; 10:1445. [PMID: 37761405 PMCID: PMC10528431 DOI: 10.3390/children10091445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023]
Abstract
Reported obesity rates for adolescents in different urban and rural areas are inconsistent. We examined indicators of healthy and unhealthy dietary patterns among 1863 adolescents aged 13-18 years with a healthy or excess body weight attending 23 secondary schools in four different settlement types across the Otago region, New Zealand. An online survey included demographics and dietary behaviours. Height and weight were measured, and body mass index was calculated. New Zealand defined urban and rural settlement types were used. Home addresses determined a small area-level index of deprivation. Data were analysed using Chi-square tests and ANOVA. A logistic model was fitted to estimate adjusted odds ratios of excess weight. The proportion of adolescents with a healthy weight differed (p < 0.001) between the most (64.9%) and least (76.4%) deprived neighbourhood areas. There was only indicative evidence of differences between settlement types (p = 0.087). Sugar-sweetened beverage and fast-food consumption was more frequent in the most deprived areas (p < 0.001), and in urban versus rural settlements (p < 0.001). The most important associations with excess weight were area-level deprivation and ethnicity, but not settlement type. Prioritising socioeconomic factors irrespective of settlement type is necessary when developing interventions to improve dietary patterns and body weight status among adolescents.
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Affiliation(s)
- Kirsten J. Coppell
- Department of Medicine, University of Otago Wellington, Wellington South 6242, New Zealand
- Nelson Marlborough Institute of Technology, Nelson 7010, New Zealand
| | - Michael Keall
- Department of Public Health, University of Otago Wellington, Wellington South 6242, New Zealand;
| | - Sandra Mandic
- School of Sport and Recreation, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland 0627, New Zealand
- Centre for Sustainability, University of Otago, Dunedin 9054, New Zealand
- AGILE Research Ltd., Wellington 6012, New Zealand
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D’Hooghe S, Inaç Y, De Clercq E, Deforche B, Dury S, Vandevijvere S, Van de Weghe N, Van Dyck D, De Ridder K. The CIVISANO protocol: a mixed-method study about the role of objective and perceived environmental factors on physical activity and eating behavior among socioeconomically disadvantaged adults. Arch Public Health 2022; 80:219. [PMID: 36199109 PMCID: PMC9533259 DOI: 10.1186/s13690-022-00956-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 08/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Overweight and obesity have a strong socioeconomic profile. Unhealthy behaviors like insufficient physical activity and an unbalanced diet, which are causal factors of overweight and obesity, tend to be more pronounced in socioeconomically disadvantaged groups in high income countries. The CIVISANO project aims to identify objective and perceived environmental factors among different socioeconomic population groups that impede or facilitate physical activity and healthy eating behavior in the local context of two peri-urban Flemish municipalities in Belgium. We also aim to identify and discuss possible local interventions and evaluate the participatory processes of the project. METHODS This study (2020-2023) will use community-based participatory tools, involving collaborative partnerships with civic and stakeholder members of the community and regular exchanges among all partners to bridge knowledge development and health promotion for socioeconomically disadvantaged citizens. Furthermore, a mixed-methods approach will be used. A population survey and geographic analysis will explore potential associations between the physical activity and eating behaviors of socioeconomically disadvantaged adults (25-65 years old) and both their perceived and objective physical, food and social environments. Profound perceptive context information will be gathered from socioeconomically disadvantaged adults by using participatory methods like photovoice, walk-along, individual map creation and group model building. An evaluation of the participatory process will be conducted simultaneously. DISCUSSION The CIVISANO project will identify factors in the local environment that might provoke inequities in adopting a healthy lifestyle. The combination of perceived and objective measures using validated strategies will provide a robust assessment of the municipality environment. Through this analysis, the project will investigate to what extent community engagement can be a useful strategy to reduce health inequities. The strong knowledge exchange and capacity-building in a local setting is expected to contribute to our understanding of how to maximize research impact in this field and generate evidence about potential linkages between a health enhancing lifestyle among socioeconomically disadvantaged groups and their physical, food and social environments.
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Affiliation(s)
- Suzannah D’Hooghe
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Yasemin Inaç
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium ,grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Eva De Clercq
- grid.508031.fSciensano, Department of Chemical and Physical Health Risks, Brussels, Belgium
| | - Benedicte Deforche
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent, Belgium ,grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Physical Education and Physiotherapy, Department of Movement and Sport Sciences, Brussels, Belgium
| | - Sarah Dury
- grid.8767.e0000 0001 2290 8069Vrije Universiteit Brussel (VUB), Faculty of Psychology and Educational Sciences, Adult Educational Sciences, Brussels, Belgium
| | - Stefanie Vandevijvere
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
| | - Nico Van de Weghe
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Sciences, Department of Geography, Ghent, Belgium
| | - Delfien Van Dyck
- grid.5342.00000 0001 2069 7798Ghent University, Faculty of Medicine and Health Sciences, Department of Movement and Sports Sciences, Brussels, Belgium
| | - Karin De Ridder
- grid.508031.fSciensano, Department of Epidemiology and Public Health, Brussels, Belgium
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Merville O, Launay L, Dejardin O, Rollet Q, Bryère J, Guillaume É, Launoy G. Can an Ecological Index of Deprivation Be Used at the Country Level? The Case of the French Version of the European Deprivation Index (F-EDI). IJERPH 2022; 19:ijerph19042311. [PMID: 35206501 PMCID: PMC8872283 DOI: 10.3390/ijerph19042311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/09/2022] [Accepted: 02/11/2022] [Indexed: 11/16/2022]
Abstract
Most ecological indices of deprivation are constructed from census data at the national level, which raises questions about the relevance of their use, and their comparability across a country. We aimed to determine whether a national index can account for deprivation regardless of location characteristics. In Metropolitan France, 43,853 residential census block groups (IRIS) were divided into eight area types based on quality of life. We calculated score deprivation for each IRIS using the French version of the European Deprivation Index (F-EDI). We decomposed the score by calculating the contribution of each of its components by area type, and we assessed the impact of removing each component and recalculating the weights on the identification of deprived IRIS. The set of components most contributing to the score changed according to the area type, but the identification of deprived IRIS remained stable regardless of the component removed for recalculating the score. Not all components of the F-EDI are markers of deprivation according to location characteristics, but the multidimensional nature of the index ensures its robustness. Further research is needed to examine the limitations of using these indices depending on the purpose of the study, particularly in relation to the geographical grid used to calculate deprivation scores.
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Du W, Wang H, Su C, Jia X, Zhang B. Thirty-Year Urbanization Trajectories and Obesity in Modernizing China. Int J Environ Res Public Health 2022; 19:ijerph19041943. [PMID: 35206130 PMCID: PMC8871544 DOI: 10.3390/ijerph19041943] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 02/02/2023]
Abstract
The effects of long-term urbanization changes in obesity are unclear. Data were obtained from the China Health and Nutrition Survey (CHNS) 1989-2018. A multidimensional urbanicity index was used to define the urbanization level for communities. Group-based trajectory modeling was used to identify distinct urbanization change trajectories. Gender-stratified multilevel models were used to investigate the association between urbanization trajectories and weight/BMI, through the PROC MIXED procedure, as well as the risk of being overweight + obesity (OO)/obesity (OB), through the PROC GLIMMIX procedure. A total of three patterns of the trajectory of change in urbanization were identified in 304 communities (with 1862 measurements). A total of 25.8% of communities had a low initial urbanization level and continuous increase (termed "LU"), 22.2% of communities had a low-middle initial urbanization level and constant increase (termed "LMU"), and 52.0% of communities had a middle-high initial urbanization and significant increase before 2009, followed by a stable platform since then (termed "MHU"). During the 30 follow-up years, a total of 69490 visits, contributed by 16768 adult participants, were included in the analysis. In the period, weight and BMI were observed in an increasing trend in all urbanization trajectory groups, among both men and women. Compared with LU, men living in MHU were related to higher weight, BMI, and an increased risk of OO (OR: 1.46, 95%CI: 1.26 to 1.69). No significant associations were found between urbanization trajectories and OB risk in men. Among women, the associations between urbanization and all obesity indicators became insignificant after controlling the covariates. Obesity indicators increased along with urbanization in the past thirty years in China. However, the differences among urbanization trajectories narrowed over time. More urbanized features were only significantly associated with a higher risk of obesity indicators in Chinese men. The effects of urbanization on obesity among women were buffered.
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