Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53705, USA.
Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI 53705, USA.
Int J Environ Res Public Health. 2023 Nov 30;20(23):7122. doi: 10.3390/ijerph20237122.
Obesity and a low socioeconomic status (SES), measured at the neighborhood level, are more common among Americans of Black race and with a low individual-level SES. We examined the association between the neighborhood SES and body mass index (BMI) using data from 80,970 participants in the Southern Community Cohort Study, a cohort that oversamples Black and low-SES participants. BMI (kg/m) was examined both continuously and categorically using cut points defined by the CDC. Neighborhood SES was measured using a neighborhood deprivation index composed of census-tract variables in the domains of education, employment, occupation, housing, and poverty. Generally, the participants in lower-SES neighborhoods were more likely to have a higher BMI and to be considered obese. We found effect modification by race and sex, where the neighborhood-BMI association was most apparent in White female participants in all the quintiles of the neighborhood SES (OR = 1.55, 95%CI = 1.34, 1.78; OR = 1.71, 95%CI = 1.48, 1.98; OR = 1.76, 95%CI = 1.52, 2.03; OR = 1.64, 95%SE = 1.39, 1.93). Conversely, the neighborhood-BMI association was mostly null in Black male participants (OR = 0.91, 95%CI = 0.72, 1.15; OR = 1.05, 95%CI = 0.84, 1.31; β = 1.00, 95%CI = 0.81, 1.23; OR = 0.76, 95%CI = 0.63, 0.93). Within all the subgroups, the associations were attenuated or null in participants residing in the lowest-SES neighborhoods. These findings suggest that the associations between the neighborhood SES and BMI vary, and that other factors aside from the neighborhood SES may better predict the BMI in Black and low-SES groups.
肥胖和低社会经济地位（SES）在黑种美国人群体中更为常见，而且在 SES 水平较低的个体中也更为常见。我们利用南方社区队列研究（Southern Community Cohort Study）中的 80970 名参与者的数据，检查了社区 SES 与身体质量指数（BMI）之间的关系。南方社区队列研究是一个对黑人和 SES 水平较低的参与者进行过抽样的队列。BMI（kg/m）既被连续地检查，也使用由疾病预防控制中心定义的切点进行分类检查。社区 SES 是通过由普查区变量组成的社区剥夺指数来衡量的，这些变量在教育、就业、职业、住房和贫困等领域。一般来说，SES 较低社区的参与者更有可能拥有较高的 BMI 并被认为肥胖。我们发现种族和性别存在效应修饰，在所有 SES 五分位数的白人女性参与者中，社区-BMI 关联最为明显（OR=1.55，95%CI=1.34，1.78；OR=1.71，95%CI=1.48，1.98；OR=1.76，95%CI=1.52，2.03；OR=1.64，95%CI=1.39，1.93）。相反，在黑人男性参与者中，社区-BMI 关联大多为零（OR=0.91，95%CI=0.72，1.15；OR=1.05，95%CI=0.84，1.31；β=1.00，95%CI=0.81，1.23；OR=0.76，95%CI=0.63，0.93）。在所有亚组中，在 SES 最低的社区居住的参与者中，关联减弱或为零。这些发现表明，社区 SES 与 BMI 之间的关联存在差异，而且除了社区 SES 之外的其他因素可能更好地预测黑人和 SES 水平较低的人群的 BMI。
