Abstract MP88: Neighborhood-Level Socioeconomic Deprivation Predicts Weight Gain in a Multi-Ethnic Population: Longitudinal Data from the Dallas Heart Study

Abstract

Background: Although neighborhood-level socioeconomic deprivation associates with prevalent obesity, its relationship to individual-level weight change over time is poorly elucidated. Few studies have evaluated the impact of behavioral and psychosocial factors on this relationship. Methods: We examined the relationship between neighborhood-level socioeconomic deprivation and weight change among those who did not move in the 7-year study period (N=955) of the Dallas Heart Study (DHS), a multi-ethnic, population-based sample of Dallas County residents aged 18-65. Baseline weight measurements were performed in 2000-02 and weight was re-measured at 7-year follow-up. Home addresses obtained at baseline and follow-up were geocoded and linked to residential census tracts in Dallas County. A neighborhood deprivation index (NDI) for DHS participants was created using factor analysis of 21 census-tract neighborhood characteristics, with higher scores indicating more socioeconomic deprivation. Repeated-measures linear mixed modeling with random effects was used to determine weight change (kg) relative to tertiles of NDI. Reported physical activity (yes/no: exercised <150 mets/min-wk) and perceptions of neighborhood environment (questionnaire-derived score with higher score = more unfavorable perceptions of neighborhood violence, aesthetics, and social cohesion) were examined as mediators. Results: DHS participants living in more socioeconomically deprived neighborhoods had lower income and education (p-trend <0.001 for both). Blacks were more likely to live in more socioeconomically deprived neighborhoods than whites and Hispanics (p<0.001). Adjusting for age, sex, race, smoking, education, and income as fixed effects, DHS participants living in the most socioeconomically deprived neighborhoods (highest NDI tertile) gained 5.8±2.5 more kilograms (p=0.02) over the 7-year period compared to those in the least deprived neighborhoods. Living in the most socioeconomically deprived neighborhoods remained associated with a 6.4±2.5 kg greater increase in weight (p=0.01) compared to living in the least deprived neighborhoods after adjustment for physical activity levels and a 6.6±2.6 kg greater increase in weight (p=0.01) after adjustment for perceptions of neighborhood environment. Conclusions: Living in more socioeconomically deprived neighborhoods is associated with greater weight gain among DHS participants over a 7-year period. This relationship does not appear to be fully explained by lower levels of physical activity or unfavorable perceptions of the neighborhood environment. In Dallas County, the high risk for greater weight gain among people living in socioeconomically deprived neighborhoods supports the need to develop targeted community-based interventions to address obesity and reduce disparities in cardiovascular risk.