Institute for Health and Ageing, Australian Catholic University, Melbourne, Australia.
Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Am J Epidemiol. 2018 Aug 1;187(8):1696-1703. doi: 10.1093/aje/kwx390.
Natural experiments, such as longitudinal observational studies that follow-up residents as they relocate, provide a strong basis to infer causation between the neighborhood environment and health. In this study, we examined whether changes in the level of neighborhood disadvantage were associated with changes in body mass index (BMI) after residential relocation. This analysis included data from 928 residents who relocated between 2007 and 2013, across 4 waves of the How Areas in Brisbane Influence Health and Activity (HABITAT) study in Brisbane, Australia. Neighborhood disadvantage was measured using a census-derived composite index. For individual-level data, participants self-reported their height, weight, education, occupation, and household income. Data were analyzed using multilevel, hybrid linear models. Women residing in less disadvantaged neighborhoods had a lower BMI, but there was no association among men. Neighborhood disadvantage was not associated with within-individual changes in BMI among men or women when moving to a new neighborhood. Despite a growing body of literature suggesting an association between neighborhood disadvantage and BMI, we found this association may not be causal among middle-aged and older adults. Observing associations between neighborhood socioeconomic disadvantage and BMI over the life course, including the impact of residential relocation at younger ages, remains a priority for future research.
自然实验，如对随着居民迁移而进行后续跟踪的纵向观察研究，可以为推断邻里环境与健康之间的因果关系提供强有力的依据。在这项研究中，我们检验了邻里劣势程度的变化是否与居民迁移后的体重指数（BMI）变化有关。该分析包括了 928 名在 2007 年至 2013 年间迁移的居民的数据，这些居民来自澳大利亚布里斯班的“布里斯班地区如何影响健康和活动（HABITAT）”研究的 4 个波次。邻里劣势通过人口普查衍生的综合指数来衡量。对于个体水平的数据，参与者自我报告了他们的身高、体重、教育、职业和家庭收入。使用多层次混合线性模型对数据进行了分析。居住在劣势程度较低的邻里的女性 BMI 较低，但男性之间没有关联。当男性或女性搬到新的邻里时，邻里劣势与 BMI 的个体内变化无关。尽管越来越多的文献表明邻里劣势与 BMI 之间存在关联，但我们发现这种关联在中年和老年人中可能不是因果关系。观察生命历程中邻里社会经济劣势与 BMI 之间的关联，包括在年轻时进行住宅迁移的影响，仍然是未来研究的重点。
