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Weight of communities: A multilevel analysis of body mass index in 32,814 neighborhoods in 57 low- to middle-income countries (LMICs)

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  • Corsi, Daniel J.
  • Finlay, Jocelyn E.
  • Subramanian, S.V.

Abstract

The extent to which body mass index (BMI) varies between small areas or neighborhoods in low- to middle-income countries (LMICs) remains unknown. Further, whether such variation is reflective of characteristics of individuals living in these neighborhoods is also not clear. We estimated the extent to which there is variation in BMI is attributable to neighborhoods in 57 LMICs. The data were from non-pregnant women of reproductive age (20–49 y) participating in Demographic and Health Surveys conducted in 57 countries between 1994 and 2008. Body mass index (BMI, weight [in kg] divided by height squared [in m2]) was used to assess weight status. Height and weight were measured objectively by trained field investigators. Age, household wealth, education were included as individual covariates and place of residence (urban or rural) as a neighborhood-level covariate. We conducted a multilevel analysis of 451,321 women (aged 20–49 y) from 32,814 neighborhoods and 57 countries. We used linear and multinomial models to partition the variation in BMI (in kg/m2), underweight (BMI <18.5 kg/m2) and overweight (BMI ≥25.0 kg/m2) at the level of neighborhoods and countries. We also explored the heterogeneity in neighborhood variation by socioeconomic status (SES). Of the total variation in BMI 17.6% was attributable to countries (Standard Deviation [SD] 2.0, 95% credible interval [CI] 1.7, 2.4) and 10.6% (SD 1.56, 95% CI 1.54, 1.58) was attributable to neighborhoods in age-adjusted models. Adjusting for individual- and neighborhood-level covariates reduced the SD attributable to countries and neighborhoods to 1.9, and 1.17, respectively. Between-country variation was 13.4% (SD 0.75, 95% CI 0.62–0.90) for underweight and 18.9% (SD 0.92, 95% CI 0.76-1.10) for overweight, and between-neighborhood variation was 7.7% (SD 0.57, 95% CI 0.55-0.58) for underweight and 7.1% (SD 0.56, 95% CI 0.55-0.58) for overweight in the fully-adjusted multinomial model. In country-specific models, the neighborhood variation in BMI ranged from 0.4 SD in Central African Republic to 2.7 SD in Sierra Leone in fully-adjusted models. Our results demonstrate a considerable range in neighborhood variation in BMI. In countries with greater neighborhood variation it is possible that BMI is being influenced by local conditions more than others with lesser neighborhood variation.

Suggested Citation

  • Corsi, Daniel J. & Finlay, Jocelyn E. & Subramanian, S.V., 2012. "Weight of communities: A multilevel analysis of body mass index in 32,814 neighborhoods in 57 low- to middle-income countries (LMICs)," Social Science & Medicine, Elsevier, vol. 75(2), pages 311-322.
    • Handle: RePEc:eee:socmed:v:75:y:2012:i:2:p:311-322
    DOI: 10.1016/j.socscimed.2012.02.014
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    1. Robert, Stephanie A. & Reither, Eric N., 2004. "A multilevel analysis of race, community disadvantage, and body mass index among adults in the US," Social Science & Medicine, Elsevier, vol. 59(12), pages 2421-2434, December.
    2. Saelens, B.E. & Sallis, J.F. & Black, J.B. & Chen, D., 2003. "Neighborhood-Based Differences in Physical Activity: An Environment Scale Evaluation," American Journal of Public Health, American Public Health Association, vol. 93(9), pages 1552-1558.
    3. Diez Roux, A.V. & Evenson, K.R. & McGinn, A.P. & Brown, D.G. & Moore, L. & Brines, S. & Jacobs Jr., D.R., 2007. "Availability of recreational resources and physical activity in adults," American Journal of Public Health, American Public Health Association, vol. 97(3), pages 493-499.
    4. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1993. "Do places matter? A multi-level analysis of regional variations in health-related behaviour in Britain," Social Science & Medicine, Elsevier, vol. 37(6), pages 725-733, September.
    5. Deon Filmer & Lant Pritchett, 2001. "Estimating Wealth Effects Without Expenditure Data—Or Tears: An Application To Educational Enrollments In States Of India," Demography, Springer;Population Association of America (PAA), vol. 38(1), pages 115-132, February.
    6. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1998. "Context, composition and heterogeneity: Using multilevel models in health research," Social Science & Medicine, Elsevier, vol. 46(1), pages 97-117, January.
    7. Krieger, N. & Chen, J.T. & Waterman, P.D. & Rehkopf, D.H. & Subramanian, S.V., 2005. "Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: The public health disparities geocoding project," American Journal of Public Health, American Public Health Association, vol. 95(2), pages 312-323.
    8. Ross, N.A. & Tremblay, S. & Khan, S. & Crouse, D. & Tremblay, M. & Berthelot, J.-M., 2007. "Body mass index in urban Canada: Neighborhood and metropolitan area effects," American Journal of Public Health, American Public Health Association, vol. 97(3), pages 500-508.
    9. Diez Roux, A.V., 2001. "Investigating neighborhood and area effects on health," American Journal of Public Health, American Public Health Association, vol. 91(11), pages 1783-1789.
    10. Ackerson, Leland K. & Kawachi, Ichiro & Barbeau, Elizabeth M. & Subramanian, S.V., 2008. "Geography of underweight and overweight among women in India: A multilevel analysis of 3204 neighborhoods in 26 states," Economics & Human Biology, Elsevier, vol. 6(2), pages 264-280, July.
    11. N/A, 2004. "Index for 2004," European Union Politics, , vol. 5(4), pages 511-512, December.
    12. Duncan, Craig & Jones, Kelvyn & Moon, Graham, 1996. "Health-related behaviour in context: A multilevel modelling approach," Social Science & Medicine, Elsevier, vol. 42(6), pages 817-830, March.
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    2. Goryakin, Yevgeniy & Suhrcke, Marc, 2014. "Economic development, urbanization, technological change and overweight: What do we learn from 244 Demographic and Health Surveys?," Economics & Human Biology, Elsevier, vol. 14(C), pages 109-127.
    3. Chandan Kumar & Rajesh Kumar Rai & Prashant Kumar Singh & Lucky Singh, 2013. "Socioeconomic Disparities in Maternity Care among Indian Adolescents, 1990–2006," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.

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