Bonney Andrew, Mayne Darren J, Jones Bryan D, Bott Lawrence, Andersen Stephen E J, Caputi Peter, Weston Kathryn M, Iverson Don C
University of Wollongong, Graduate School of Medicine, Wollongong, New South Wales, 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, New South Wales, 2522, Australia.
Public Health, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, 2500, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, New South Wales, 2522, Australia; Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, 2006, Australia.
PLoS One. 2015 Aug 28;10(8):e0137261. doi: 10.1371/journal.pone.0137261. eCollection 2015.
Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities.
The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable.
The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males.
It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.
超重和肥胖会增加个体寻求初级医疗服务的可能性，但地区层面的肥胖率估计数据却很少，这不利于卫生服务规划。本文分析了一个来自社区的大型临床数据库，该数据库对体重指数（BMI）进行了客观测量，以探讨其与地区层面社会经济劣势的关系，从而为地区层面的规划活动提供参考。
该研究纳入了91776名成年人，他们在2009年7月1日至2011年6月30日期间由单一病理检测机构对BMI进行了客观测量。提取了人口统计学数据和BMI，并通过地理编码将其与2006年全国人口普查社会经济数据进行匹配。使用性别分层的逻辑回归模型，以居住的人口普查收集区的社会经济劣势为自变量，计算超重和肥胖的调整比值比。
超重或肥胖的患病率男性为79.2%，女性为65.8%；随年龄增长至74岁；农村地区（74%）高于城市地区（71.4%）（p<0.001）。社会经济劣势增加与女性超重（p<0.0001）、肥胖（p<0.0001）和超重或肥胖（p<0.0001）以及男性肥胖（p<0.0001）的患病率增加相关。社会经济劣势与男性超重（p = 0.2024）和超重或肥胖（p = 0.4896）无关。
将常规收集的、代表特定人群的临床数据与劣势的地理分布联系起来，并获得有助于针对干预措施以改善人群健康的有意义的地区层面信息是可行的。我们的研究结果表明，超重和肥胖存在与地区卫生服务规划相关的新的地区层面社会经济梯度。
