Department of Community Health and Psychiatry, University of the West Indies, Mona, Jamaica.
Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, United States of America.
PLoS One. 2021 Apr 5;16(4):e0249619. doi: 10.1371/journal.pone.0249619. eCollection 2021.
To examine whether proximity and density of public open spaces, public parks, street connectivity, and serious and violent crimes were associated with Body Mass Index (BMI) and Waist Circumference (WC) within and across levels of urbanicity, sex and socioeconomic status (SES) in Jamaica, a small island developing state (SIDS).
Secondary analysis was conducted using data from the Jamaica Health and Lifestyle Survey 2008 (JHLS II). All respondents were geocoded to area of residence in Enumeration Districts (EDs). Intraclass correlation coefficients (ICCs) were derived and multilevel mixed effects regression models applied to 2529 participants nested within 101 EDs from all 14 parishes in Jamaica.
There was significant clustering across neighborhoods for mean BMI (ICC = 4.16%) and mean WC (ICC = 4.42%). In fully adjusted models statistically significant associations included: increased mean BMI among men, with increased intersection density/ km2 (β = 0.02; 95% CI = 1.96 x10-3, 0.04, p = 0.032); increased mean WC among urban residents with increased crimes/km2/yr (β = 0.09; 95% CI = 0.03, 0.16, p<0.01) and among persons in the middle class, with further distance away from public parks (β = 0.30; 95% CI = 0.08, 0.53, p<0.01).
Neighborhood physical and crime environments were associated with obesity-related outcomes in Jamaica. Policymakers in SIDS such as Jamaica should also note the important differences by urbanicity, sex and SES in prevention efforts designed to stem the growing obesity epidemic.
在牙买加，一个小岛屿发展中国家，检验公共开放空间、公园的临近度和密度、街道连通性以及严重和暴力犯罪与 BMI 和 WC 之间和之间的城市化水平、性别和社会经济地位（SES）的关系。
使用 2008 年牙买加健康与生活方式调查（JHLS II）的数据进行二次分析。所有受访者都被地理编码到居住在普查区（EDs）的区域。得出了组内相关系数（ICCs），并将多水平混合效应回归模型应用于来自牙买加所有 14 个教区的 101 个 ED 中的 2529 名嵌套参与者。
在整个社区中，BMI 的平均值（ICC = 4.16%）和 WC 的平均值（ICC = 4.42%）都存在显著的聚类现象。在完全调整的模型中，有统计学意义的关联包括：男性的平均 BMI 随着交叉口密度/ km2 的增加而增加（β=0.02；95%置信区间为 1.96 x10-3，0.04，p = 0.032）；城市居民的平均 WC 随着犯罪/ km2/yr 的增加而增加（β=0.09；95%置信区间为 0.03，0.16，p<0.01），以及中产阶级的人，随着与公园的距离进一步增加（β=0.30；95%置信区间为 0.08，0.53，p<0.01）。
邻里的物理和犯罪环境与牙买加的肥胖相关结果有关。像牙买加这样的小岛屿发展中国家的决策者还应注意城市化水平、性别和 SES 对预防工作的重要差异，以遏制日益严重的肥胖流行。
