Pennington Biomedical Research Center, 6400 Perkins Rd, Baton Rouge, Baton Rouge, LA, 70808, USA.
School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
BMC Public Health. 2023 Sep 1;23(1):1692. doi: 10.1186/s12889-023-16580-0.
Disadvantaged neighborhood environments are a source of chronic stress which undermines optimal adolescent health. This study investigated relationships between the neighborhood social environment, specifically, chronic stress exposures, adiposity, and cardiometabolic disease risk factors among 288 Louisiana adolescents aged 10 to 16 years.
This cross-sectional study utilized baseline data from the Translational Investigation of Growth and Everyday Routines in Kids (TIGER Kids) study. Adolescent data were obtained using self-reported questionnaires (demographics and perceived neighborhood disorder), anthropometry, body imaging, and a blood draw while objective neighborhood data for the concentrated disadvantage index were acquired from the 2016 American Community Survey five-year block group estimates, 2012-2016. Multilevel linear regression models were used to examine whether neighborhood concentrated disadvantage index and perceived neighborhood disorder were associated with body mass index, waist circumference, body fat, adipose tissue, blood pressure, and lipids. We performed multilevel logistic regression to determine the odds of elevated adiposity and cardiometabolic disease risk for adolescents living in neighborhoods with varying levels of neighborhood concentrated disadvantage and disorder.
Adolescents living in neighborhoods with higher disadvantage or disorder had greater waist circumference and total percent body fat compared to those in less disadvantaged and disordered neighborhoods (p for trend < 0.05). Neighborhood disadvantage was also positively associated with percentage of the 95 Body Mass Index percentile and visceral abdominal adipose tissue mass while greater perceived neighborhood disorder was related to higher trunk fat mass and diastolic blood pressure (p for trend < 0.05). Living in the most disadvantaged was associated with greater odds of obesity (OR: 2.9, 95% CI:1.3, 6.5) and being in the top tertile of body fat mass (OR: 3.0, 95% CI: 1.4, 6.6). Similar results were found with neighborhood disorder for odds of obesity (OR: 2.1, 95% CI:1.1, 4.2) and top tertile of body fat mass (OR: 2.1, 95% CI:1.04, 4.1).
Neighborhood social environment measures of chronic stress exposure were associated with excess adiposity during adolescence, and relationships were most consistently identified among adolescents living in the most disadvantaged and disordered neighborhoods. Future studies should account for the influences of the neighborhood environment to stimulate equitable improvements in adolescent health. CLINICAL TRIALS REGISTRATION: # NCT02784509.
不利的社区环境是慢性压力的来源，这种压力破坏了青少年的最佳健康。本研究调查了社区社会环境（特别是慢性压力暴露）与路易斯安那州 288 名 10 至 16 岁青少年的肥胖和心血管代谢疾病风险因素之间的关系。
本横断面研究利用了 Translational Investigation of Growth and Everyday Routines in Kids（TIGER Kids）研究的基线数据。青少年数据通过自我报告问卷（人口统计学和感知社区障碍）、人体测量、身体成像和血液采集获得，而集中劣势指数的客观社区数据则来自 2016 年美国社区调查五年组估计数，2012-2016 年。使用多层次线性回归模型来检验邻里集中劣势指数和感知邻里障碍是否与体重指数、腰围、体脂肪、脂肪组织、血压和血脂有关。我们进行了多层次逻辑回归分析，以确定居住在不同邻里集中劣势和障碍程度的青少年发生肥胖和心血管代谢疾病风险的几率。
与居住在劣势和障碍程度较低的社区的青少年相比，居住在劣势或障碍程度较高的社区的青少年腰围和总体脂肪百分比更大（趋势 < 0.05）。邻里劣势也与 95%体重指数百分位数的百分比和内脏腹部脂肪组织质量呈正相关，而感知邻里障碍与更高的躯干脂肪质量和舒张期血压相关（趋势 < 0.05）。居住在最不利地区与肥胖的几率更大有关（OR：2.9，95%CI：1.3，6.5），并且处于体脂质量最高三分位的几率更高（OR：3.0，95%CI：1.4，6.6）。对于肥胖（OR：2.1，95%CI：1.1，4.2）和体脂质量最高三分位（OR：2.1，95%CI：1.04，4.1），社区障碍的结果也相似。
慢性压力暴露的邻里社会环境措施与青少年时期的肥胖有关，并且在居住在最不利和最混乱的社区的青少年中，这些关系最为一致。未来的研究应考虑到邻里环境的影响，以促进青少年健康的公平改善。临床试验注册：#NCT02784509。
