Powell-Wiley Tiffany M, Cooper-McCann Rebecca, Ayers Colby, Berrigan David, Lian Min, McClurkin Michael, Ballard-Barbash Rachel, Das Sandeep R, Hoehner Christine M, Leonard Tammy
Cardiovascular and Pulmonary Branch, National Heart, Lung.
Blood Institute; Clinical Center, Office of Clinical Research Training and Medical Education, NIH, Bethesda.
Am J Prev Med. 2015 Jul;49(1):72-9. doi: 10.1016/j.amepre.2015.01.013. Epub 2015 May 8.
Despite a proposed connection between neighborhood environment and obesity, few longitudinal studies have examined the relationship between change in neighborhood socioeconomic deprivation, as defined by moving between neighborhoods, and change in body weight. The purpose of this study is to examine the longitudinal relationship between moving to more socioeconomically deprived neighborhoods and weight gain as a cardiovascular risk factor.
Weight (kilograms) was measured in the Dallas Heart Study (DHS), a multiethnic cohort aged 18-65 years, at baseline (2000-2002) and 7-year follow-up (2007-2009, N=1,835). Data were analyzed in 2013-2014. Geocoded addresses were linked to Dallas County, TX, census block groups. A block group-level neighborhood deprivation index (NDI) was created. Multilevel difference-in-difference models with random effects and a Heckman correction factor (HCF) determined weight change relative to NDI change.
Forty-nine percent of the DHS population moved (263 to higher NDI, 586 to lower NDI, 47 within same NDI), with blacks more likely to move than whites or Hispanics (p<0.01), but similar baseline BMI and waist circumference were observed in movers versus non-movers (p>0.05). Adjusting for HCF, sex, race, and time-varying covariates, those who moved to areas of higher NDI gained more weight compared to those remaining in the same or moving to a lower NDI (0.64 kg per 1-unit NDI increase, 95% CI=0.09, 1.19). Impact of NDI change on weight gain increased with time (p=0.03).
Moving to more-socioeconomically deprived neighborhoods was associated with weight gain among DHS participants.
尽管有人提出社区环境与肥胖之间存在关联，但很少有纵向研究探讨社区社会经济剥夺程度的变化（通过在不同社区之间迁移来定义）与体重变化之间的关系。本研究的目的是检验迁移到社会经济剥夺程度更高的社区与体重增加作为心血管危险因素之间的纵向关系。
在达拉斯心脏研究（DHS）中对体重（千克）进行了测量，该研究是一个多民族队列，年龄在18 - 65岁之间，在基线期（2000 - 2002年）和7年随访期（2007 - 2009年，N = 1835）进行测量。数据于2013 - 2014年进行分析。地理编码地址与德克萨斯州达拉斯县的人口普查街区组相关联。创建了一个街区组层面的社区剥夺指数（NDI）。采用具有随机效应和赫克曼校正因子（HCF）的多层次差分模型来确定相对于NDI变化的体重变化。
DHS人群中有49%发生了迁移（263人迁移到NDI更高的地区，586人迁移到NDI更低的地区，47人留在相同NDI地区），黑人比白人和西班牙裔更有可能迁移（p < 0.01），但迁移者与未迁移者的基线BMI和腰围相似（p > 0.05）。在调整了HCF、性别、种族和随时间变化的协变量后，与留在相同地区或迁移到NDI更低地区的人相比，迁移到NDI更高地区的人体重增加更多（NDI每增加1个单位，体重增加0.64千克，95%置信区间 = 0.09，1.19）。NDI变化对体重增加的影响随时间增加（p = 0.03）。
迁移到社会经济剥夺程度更高的社区与DHS参与者的体重增加有关。
