Harvard University, Graduate School of Design, Advanced Studies Program, Cambridge, MA, USA.
Public Health Rep. 2011 Sep-Oct;126(5):700-7. doi: 10.1177/003335491112600512.
This study examined disparities in the prevalence of obesity to determine how future prevention and/or intervention efforts should be developed to remedy obesity.
We obtained individual information of sociodemographic characteristics, comorbid conditions, and lifestyle behaviors from the Boston Area Community Health (BACH) survey for 2002-2005. To account for the complex BACH sampling design, observations were weighted inversely to their probability of selection, and sampling weights were poststratified to the Boston population from the U.S. Census 2000. We tested all possible two- and three-way interaction terms from a multivariate logistic regression model.
After controlling for individual determinants in detail and focusing on the population within a single city, the associations of sociodemographic characteristics, comorbid conditions, and lifestyle behaviors with obesity were consistent with previous findings. Notably, three two-way interaction terms were significantly associated with obesity: (1) race/ethnicity and gender, (2) gender and other people in the household, and (3) race/ethnicity and alcohol consumption.
Future obesity prevention and/or intervention programs in Boston need to be primarily gender- and racially/ethnically specific to minimize cost and maximize results. Additional considerations are needed to take into account the differences in age, the presence of other people in the household, and education level.
本研究旨在探讨肥胖的流行差异,以确定未来应如何制定预防和/或干预措施来解决肥胖问题。
我们从 2002 年至 2005 年的波士顿地区社区健康(BACH)调查中获得了个人的社会人口特征、合并症和生活方式行为信息。为了考虑到 BACH 复杂的抽样设计,我们将观察结果与它们被选中的概率成反比进行加权,并根据美国人口普查 2000 年对抽样权重进行了后分层,以适应波士顿的人口情况。我们从多变量逻辑回归模型中测试了所有可能的双变量和三变量交互项。
在详细控制个体决定因素并关注单个城市内的人群后,社会人口特征、合并症和生活方式行为与肥胖的关联与先前的研究结果一致。值得注意的是,有三个双变量交互项与肥胖显著相关:(1)种族/民族和性别,(2)性别和家庭中的其他人,以及(3)种族/民族和饮酒。
未来在波士顿开展的肥胖预防和/或干预计划需要主要针对性别和种族/民族进行具体制定,以最小化成本并最大化效果。还需要考虑到年龄、家庭中其他人的存在以及教育水平的差异。