PDF(Pubmed)
Abstract：
BACKGROUND: Obesity is a global health problem, and its connection with social and environmental factors is well-established. Social factors, such as urban segregation, may impact obesity through various mechanisms, including food and physical activity environments, as well as social norms and networks. This multilevel study aims to examine the effect of socio-economic residential segregation of Latin American cities on the obesity of individuals within those cities.
METHODS: We analyzed data from national surveys for a total of 59,340 individuals of 18-70 years of age, conducted in 156 cities across Brazil, Chile, Colombia, and Mexico between 2007 and 2013. We adjusted two-level linear mixed models for body mass index (BMI) stratified by sex and country, controlling for age, educational level and poverty. Separate models were built for dissimilarity and isolation segregation indices.
RESULTS: The relationships between segregation indices and BMI were mostly not statistically significant, and in some cases, they were opposite to what was expected. The only significant relationships were observed in Colombian men, using the dissimilarity index (-7.5 [95% CI: -14.4, -0.5]) and in Colombian women, using the isolation index (-7.9 [95% CI: -14.1, -1.7]).
CONCLUSIONS: While individual-level factors cannot fully explain differences among people in the same city, segregation indices may help. However, we found that in some cases, the relationship between BMI and segregation indices is opposite to what is expected based on prior literature. This should be considered in examining the phenomenon. Further research on obesogenic environments in segregated neighborhoods could provide valuable evidence.
METHODS: We analyzed data from national surveys for a total of 59,340 individuals of 18-70 years of age, conducted in 156 cities across Brazil, Chile, Colombia, and Mexico between 2007 and 2013. We adjusted two-level linear mixed models for body mass index (BMI) stratified by sex and country, controlling for age, educational level and poverty. Separate models were built for dissimilarity and isolation segregation indices.
RESULTS: The relationships between segregation indices and BMI were mostly not statistically significant, and in some cases, they were opposite to what was expected. The only significant relationships were observed in Colombian men, using the dissimilarity index (-7.5 [95% CI: -14.4, -0.5]) and in Colombian women, using the isolation index (-7.9 [95% CI: -14.1, -1.7]).
CONCLUSIONS: While individual-level factors cannot fully explain differences among people in the same city, segregation indices may help. However, we found that in some cases, the relationship between BMI and segregation indices is opposite to what is expected based on prior literature. This should be considered in examining the phenomenon. Further research on obesogenic environments in segregated neighborhoods could provide valuable evidence.
摘要：
背景：肥胖是一个全球性的健康问题，它与社会和环境因素的联系已经确立。社会因素,比如城市隔离，可能通过各种机制影响肥胖，包括食物和身体活动环境，以及社会规范和网络。这项多层次研究旨在研究拉丁美洲城市的社会经济居住隔离对这些城市中个人肥胖的影响。
方法：我们分析了总共59,340名18-70岁的个人的国家调查数据，在巴西的156个城市进行，智利,哥伦比亚,墨西哥在2007年至2013年之间。我们调整了按性别和国家分层的体重指数（BMI）的两级线性混合模型，控制年龄，教育水平和贫困。为相异和隔离隔离指数建立了单独的模型。
结果：隔离指数与BMI之间的关系大多没有统计学意义，在某些情况下,他们与预期相反。唯一重要的关系是在哥伦比亚男性中观察到的，使用差异指数（-7.5[95%CI：-14.4，-0.5]）和哥伦比亚女性，使用隔离指数（-7.9[95%CI：-14.1，-1.7]）。
结论：虽然个体层面的因素不能完全解释同一城市人群之间的差异，隔离指数可能会有所帮助。然而,我们发现在某些情况下，BMI和隔离指数之间的关系与先前文献的预期相反。在检查这种现象时应该考虑到这一点。对隔离社区中的肥胖环境的进一步研究可以提供有价值的证据。
方法：我们分析了总共59,340名18-70岁的个人的国家调查数据，在巴西的156个城市进行，智利,哥伦比亚,墨西哥在2007年至2013年之间。我们调整了按性别和国家分层的体重指数（BMI）的两级线性混合模型，控制年龄，教育水平和贫困。为相异和隔离隔离指数建立了单独的模型。
结果：隔离指数与BMI之间的关系大多没有统计学意义，在某些情况下,他们与预期相反。唯一重要的关系是在哥伦比亚男性中观察到的，使用差异指数（-7.5[95%CI：-14.4，-0.5]）和哥伦比亚女性，使用隔离指数（-7.9[95%CI：-14.1，-1.7]）。
结论：虽然个体层面的因素不能完全解释同一城市人群之间的差异，隔离指数可能会有所帮助。然而,我们发现在某些情况下，BMI和隔离指数之间的关系与先前文献的预期相反。在检查这种现象时应该考虑到这一点。对隔离社区中的肥胖环境的进一步研究可以提供有价值的证据。
