Neighborhood Social Cohesion and Obesity in the United States

Dana M Alhasan; Symielle A Gaston; Lauren Gullett; W Braxton Jackson 2nd; Fatima Cody Stanford; Chandra L Jackson

doi:10.1016/j.endmts.2023.100129

Neighborhood Social Cohesion and Obesity in the United States

Endocr Metab Sci. 2023 Jun 30:11:100129. doi: 10.1016/j.endmts.2023.100129. Epub 2023 Apr 27.

Authors

Dana M Alhasan¹, Symielle A Gaston¹, Lauren Gullett¹, W Braxton Jackson 2nd², Fatima Cody Stanford³, Chandra L Jackson^{1

4}

Affiliations

¹ Epidemiology Branch, National Institute of Environmental Health Sciences, National Institute of Health, Department of Health and Human Services, Research Triangle Park, NC, USA.
² Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, USA.
³ Neuroendocrine Unit, Pediatric Endocrinology and Nutrition Obesity Research Center at Harvard, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁴ Intramural Research Program, National Institute on Minority Health and Health Disparities, Bethesda, Maryland, USA.

PMID: 37396161
PMCID: PMC10310065 (available on 2024-06-30)
DOI: 10.1016/j.endmts.2023.100129

Abstract

Low neighborhood social cohesion (nSC) has been associated with obesity. Still, few studies have assessed the nSC-obesity relationship among a large, nationally representative, and racially/ethnically diverse sample of the United States population. To address this literature gap, we examined cross-sectional associations among 154,480 adult participants of the National Health Interview Survey (NHIS) from 2013-2018. We also determined if associations varied by race/ethnicity, sex/gender, age, annual household income, and food security status. Based on a 4-item scale from the Project on Human Development in Chicago Neighborhoods Community Survey, we categorized nSC as low, medium, and high. Based on body mass index (BMI) recommendations, we categorized obesity as ≥30 kg/m². We used Poisson regression with robust variance to directly estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) while adjusting for sociodemographic characteristics, such as annual household income, educational attainment, and marital status, along with other confounders. Study participants' mean age ± standard error was 47.1±0.1 years; most (69.2%) self-identified as Non-Hispanic (NH)-White, and 51.0% were women. NH-Black and Hispanic/Latinx adults comprised more of the population in neighborhoods with low nSC (14.0% NH-Black, 19.1% Hispanic/Latinx, and 61.8% NH-White) versus high nSC (7.7% NH-Black, 10.4% Hispanic/Latinx and 77.0% NH-White). Low vs. high nSC was associated with a 15% higher prevalence of obesity (PR=1.15 [95% CI: 1.12-1.18]), and the magnitude of the association was more substantial among NH-White (PR=1.21 [95% CI: 1.17-1.25]) compared to associations among Hispanic/Latinx (PR=1.04 [95% CI: 0.97-1.11]) and NH-Black (PR=1.01 [95% CI: 0.95-1.07]) adults. Low vs. high nSC was associated with a 20% higher prevalence of obesity in women (PR=1.20 [95% CI: 1.16-1.24]) compared to a 10% higher prevalence in men (PR=1.10 [95% CI: 1.06-1.14]). Low vs. high nSC was associated with a 19% higher prevalence of obesity among adults ≥50 years old (PR=1.19 [95% CI: 1.15-1.23]) compared to a 7% higher prevalence of obesity among adults <50 years old (PR=1.07 [95% CI: 1.03-1.11]). Efforts to address nSC may improve health and address health disparities.

Keywords: Body Mass Index; Community support; Minority groups; Obesity; Residence characteristics; Social support.

Abstract

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