King T, Kavanagh A M, Jolley D, Turrell G, Crawford D
Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia.
Int J Obes (Lond). 2006 Feb;30(2):281-7. doi: 10.1038/sj.ijo.0803176.
To estimate variation between small areas in adult body mass index (BMI), and assess the importance of area level socioeconomic disadvantage in predicting BMI.
We identified all census collector districts (CCDs) in the 20 innermost Local Government Areas in metropolitan Melbourne, Australia, and ranked them by the percentage of low income households (< dollar 400/week). In all, 50 CCDs were randomly selected from the least, middle and most disadvantaged septiles of the ranked list and 4913 residents (61.4% participation rate) completed one of two surveys. Multilevel linear regression was used to estimate area level variance in BMI and the importance of area level socioeconomic disadvantage in predicting BMI.
There were significant variations in BMI between CCDs for women, even after adjustment for individual and area SES (P = 0.012); significant area variation was not found for men. Living in the most versus least disadvantaged areas was associated with an average difference in BMI of 1.08 kg/m2 (95% CI: 0.48-1.68 kg/m2) for women, and of 0.93 kg/m2 (95% CI: 0.32-1.55 kg/m2) for men. Living in the mid versus least disadvantaged areas were associated with an average difference in BMI of 0.67 kg/m2 (95% CI: 0.09-1.26 kg/m2) for women, and 0.43 kg/m2 for men (95% CI: -0.16-1.01).
These findings suggest that area disadvantage is an important predictor of adult BMI, and support the need to focus on improving local environments to reduce socioeconomic inequalities in overweight and obesity.
评估成年人体重指数（BMI）在小区域之间的差异，并评估区域层面社会经济劣势在预测BMI方面的重要性。
我们确定了澳大利亚墨尔本大都市最内层20个地方政府区域内的所有普查收集区（CCD），并按低收入家庭（每周收入低于400澳元）的百分比对其进行排名。总共从排名列表中最弱势、中等和最不弱势的七分位数中随机选择了50个CCD，4913名居民（参与率61.4%）完成了两项调查之一。采用多水平线性回归来估计BMI的区域层面差异以及区域层面社会经济劣势在预测BMI方面的重要性。
即使在对个体和区域社会经济地位进行调整后，女性在CCD之间的BMI仍存在显著差异（P = 0.012）；男性未发现显著的区域差异。对于女性，生活在最弱势地区与最不弱势地区相比，BMI平均差异为1.08kg/m²（95%置信区间：0.48 - 1.68kg/m²），男性为0.93kg/m²（95%置信区间：0.32 - 1.55kg/m²）。对于女性，生活在中等弱势地区与最不弱势地区相比，BMI平均差异为0.67kg/m²（95%置信区间：0.09 - 1.26kg/m²），男性为0.43kg/m²（95%置信区间： - 0.16 - 1.01）。
这些发现表明区域劣势是成年人BMI的重要预测因素，并支持需要关注改善当地环境以减少超重和肥胖方面的社会经济不平等。
