Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas Health Science Center at Houston School of Public Health, Houston.
Institute on Metropolitan Opportunity, University of Minnesota, Minneapolis.
JAMA Netw Open. 2022 Sep 1;5(9):e2230697. doi: 10.1001/jamanetworkopen.2022.30697.
Neighborhood environment is an important factor associated with population disparities in obesity. However, few studies have examined whether and in what ways long-term trajectories of neighborhood conditions may be associated with weight outcomes. Moreover, there is a lack of research focusing on multidimensional and nuanced measures that make distinctions between multiple types of neighborhood change (eg, gentrification vs overall growth).
To examine the association between long-term neighborhood economic trajectories and changes in weight status among Black and White adults residing in predominantly low-income communities in the southeastern US.
DESIGN, SETTING, AND PARTICIPANTS: This study was a longitudinal analysis of participants in the Southern Community Cohort Study. Five types of neighborhood economic trajectories (stability, growth, displacement, abandonment, and poverty concentration) were measured using data from the US Census and the American Community Survey from 2000 to 2016. Data were analyzed from December 12, 2021, to July 16, 2022. A total of 33 621 Black and White adults in the southeastern US were included in the analytic sample.
Neighborhood economic trajectory.
Substantial weight gain and substantial weight loss (ie, gaining or losing ≥10% of baseline weight) between baseline (March 2002 to September 2009) and follow-up (November 2008 to January 2013) periods were assessed using self-reported information.
Among 33 621 participants, the mean (SD) age was 53.4 (8.8) years; 22 116 participants (65.8%) were women, 21 782 (64.8%) were Black, and 11 839 (35.2%) were White. Compared with residents in neighborhoods with stable trajectories, those in neighborhoods with growth trajectories that did not displace original residents were less likely to experience substantial weight gain (odds ratio [OR], 0.75; 95% CI, 0.58-0.97), whereas those in neighborhoods with poverty concentration trajectories were more likely to experience substantial weight gain (OR, 1.08; 95% CI, 1.00-1.17). These patterns appeared stronger among Black participants (eg, substantial weight gain in poverty concentration group: OR, 1.10 [95% CI, 1.00-1.22]; in growth group: OR, 0.76 [95% CI, 0.56-1.02]) compared with White participants (eg, substantial weight gain in poverty concentration group: OR, 1.03 [95% CI, 0.90-1.18]; in growth group: OR, 0.84 [95% CI, 0.52-1.36]). Differences in patterns were also observed among men (eg, substantial weight gain in poverty concentration group: OR, 1.02 [95% CI, 0.88-1.17]; in growth group: OR, 0.58 [95% CI, 0.35-0.96]) compared with women (eg, substantial weight gain in poverty concentration group: OR, 1.12 [95% CI, 1.02-1.23]; in growth group: OR, 0.83 [95% CI, 0.62-1.12]). However, none of the interaction terms between Black vs White participants and men vs women were statistically significant. Neighborhood trajectory was not associated with substantial weight loss (poverty concentration group: OR, 1.00 [95% CI, 0.93-1.09]; abandonment group: OR, 1.01 [95% CI, 0.84-1.15]; displacement group: OR, 1.04 [95% CI, 0.83-1.23]; growth group: OR, 0.88 [95% CI, 0.69-1.12]).
In this cohort study, neighborhood economic trajectories were associated with weight gain. These findings highlight the importance of using more nuanced and multidimensional measures of neighborhood change in public health research.
邻里环境是与肥胖人群差异相关的一个重要因素。然而，很少有研究探讨长期的邻里环境轨迹是否以及以何种方式与体重结果相关。此外，缺乏关注多维和细微差别的研究，这些研究区分了多种类型的邻里变化（例如，高档化与整体增长）。
研究美国东南部以低收入社区为主的黑人和白人成年人的长期邻里经济轨迹与体重状况变化之间的关联。
设计、地点和参与者：本研究是对南方社区队列研究参与者的纵向分析。使用美国人口普查和美国社区调查 2000 年至 2016 年的数据，测量了五种邻里经济轨迹（稳定、增长、流离失所、废弃和贫困集中）。数据分析于 2021 年 12 月 12 日至 2022 年 7 月 16 日进行。总共纳入了美国东南部 33621 名黑人和白人成年人进行分析。
邻里经济轨迹。
使用自我报告的信息评估基线（2002 年 3 月至 2009 年 9 月）和随访（2008 年 11 月至 2013 年 1 月）期间之间的大量体重增加和大量体重减轻（即体重增加或减轻≥10%的基线体重）。
在 33621 名参与者中，平均（SD）年龄为 53.4（8.8）岁；22116 名参与者（65.8%）为女性，21782 名（64.8%）为黑人，11839 名（35.2%）为白人。与居住在稳定轨迹社区的居民相比，那些没有流离失所原始居民的增长轨迹社区的居民不太可能经历大量体重增加（比值比[OR]，0.75；95%置信区间[CI]，0.58-0.97），而那些处于贫困集中轨迹社区的居民更有可能经历大量体重增加（OR，1.08；95%CI，1.00-1.17）。这些模式在黑人参与者中似乎更强（例如，贫困集中组的大量体重增加：OR，1.10[95%CI，1.00-1.22]；增长组：OR，0.76[95%CI，0.56-1.02]），而与白人参与者相比（例如，贫困集中组的大量体重增加：OR，1.03[95%CI，0.90-1.18]；增长组：OR，0.84[95%CI，0.52-1.36]）。在男性参与者中（例如，贫困集中组的大量体重增加：OR，1.02[95%CI，0.88-1.17]；增长组：OR，0.58[95%CI，0.35-0.96]）也观察到了差异，而与女性参与者相比（例如，贫困集中组的大量体重增加：OR，1.12[95%CI，1.02-1.23]；增长组：OR，0.83[95%CI，0.62-1.12]）。然而，黑人参与者与白人参与者和男性参与者与女性参与者之间的交互项均无统计学意义。邻里轨迹与大量体重减轻无关（贫困集中组：OR，1.00[95%CI，0.93-1.09]；废弃组：OR，1.01[95%CI，0.84-1.15]；流离失所组：OR，1.04[95%CI，0.83-1.23]；增长组：OR，0.88[95%CI，0.69-1.12]）。
在这项队列研究中，邻里经济轨迹与体重增加相关。这些发现强调了在公共卫生研究中使用更细致和多维的邻里变化衡量标准的重要性。
