Neighbourhood deprivation and overweight: the GLOBE study

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Abstract
BACKGROUND: Increasing morbidity and mortality rates of coronary heart disease (CHD) by increasing levels of neighbourhood deprivation may be explained by a positive association between neighbourhood deprivation and risk factors of CHD. In this study we investigated the association between neighbourhood deprivation and overweight. Further, we examined whether this association was modified by educational level, age and sex of the neighbourhood residents. METHODS: Data were used from 8897 subjects who participated in the baseline measurement of the Dutch GLOBE Study in 1991 and lived in 86 neighbourhoods of the fifth largest city in The Netherlands (Eindhoven). Neighbourhood deprivation was based on aggregated self-reported information about educational and occupational level and employment status. Self-reported body height and body weight were used to define overweight body mass index ((BMI) ≥25). RESULTS: Adjusted for educational level, age and sex of neighbourhood residents, odds ratios of overweight increased significantly by increasing neighbourhood deprivation (odds ratio=1.20, 95% CI 1.02, 1.41 in the highest vs lowest quartile of neighbourhood deprivation). Stratified analyses showed a stronger association between neighbourhood deprivation and overweight in females compared to males, and in older (≥49 y of age) compared to younger participants. The pattern of increasing odds ratios of overweight by neighbourhood deprivation was generally similar in all educational groups, the highest educational group being the exception with no association between neighbourhood deprivation and overweight. CONCLUSIONS: Increased prevalence rates of overweight in more compared to less deprived neighbourhoods are likely to contribute to the positive association between neighbourhood deprivation and CHD. Our results justify the development of a community-based strategy of primary prevention of overweight in deprived neighbourhoods, which may have a larger impact in females and older residents in particular. Prior to implementation, however, longitudinal research needs to further examine responsible mechanisms for the development of neighbourhood inequalities in overweight.