The Association between Obesity and Neighborhood Deprivation among Korean Adults: Using A Multilevel Analysis
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Purpose: Obesity is a risk factor for all cause death. In these days, it has been widely accepted that environmental elements and Socioeconomic Status (SES) of neighborhood can play important roles in causing chronic diseases including obesity. Methods: We analyzed total 214,630 adults aged over 19 who participated in Community Health Survey in 2014. Individual SES was measured by age, sex, educational level, job status, and marriage status. Neighborhood SES was measured by using the deprivation index (DI) at town level representing overall neighborhood SES. The association between obesity and individual SES was examined by using odds ratios with 95% confidential intervals (CIs) calculated by simple logistic regression analysis. To consider the contextual effect of neighborhood SES, multilevel analysis was performed. Results: The obesity rates were different sexually in age, educational level, job status, and marriage status. Males who had jobs with low income expected had lower ORs. By Multilevel analysis, the Median Odd Ratio (MOR) in male was 1.08 and the MOR in female 1.14. Women with higher educational level had lower ORs, but reversed results were shown in men. Males with high neighborhood SES by low DI have low OR 0.94(95% CI, 0.89, 0.99; p-value, .016). Conclusion: Neighborhood SES as well as individual had considerable impact on the prevalence of obesity in Korean adults, especially female adults with higher MOR by multilevel analysis.
Abstract
Purpose: Obesity is a risk factor for all cause death. In these days, it has been widely accepted that environmental elements and Socioeconomic Status (SES) of neighborhood can play important roles in causing chronic diseases including obesity. Methods: We analyzed total 214,630 adults aged over 19 who participated in Community Health Survey in 2014. Individual SES was measured by age, sex, educational level, job status, and marriage status. Neighborhood SES was measured by using the deprivation index (DI) at town level representing overall neighborhood SES. The association between obesity and individual SES was examined by using odds ratios with 95% confidential intervals (CIs) calculated by simple logistic regression analysis. To consider the contextual effect of neighborhood SES, multilevel analysis was performed. Results: The obesity rates were different sexually in age, educational level, job status, and marriage status. Males who had jobs with low income expected had lower ORs. By Multilevel analysis, the Median Odd Ratio (MOR) in male was 1.08 and the MOR in female 1.14. Women with higher educational level had lower ORs, but reversed results were shown in men. Males with high neighborhood SES by low DI have low OR 0.94(95% CI, 0.89, 0.99; p-value, .016). Conclusion: Neighborhood SES as well as individual had considerable impact on the prevalence of obesity in Korean adults, especially female adults with higher MOR by multilevel analysis.
참고문헌 (36)
- Adams KF, "Overweight, obesity, and mortality in a large prospective cohort of persons 50 to 71 years old", N Engl J Med, 355(8), pp.763~778 (2006)
- 정백근, "한국인 성인 비만의 사회경제적 비용", 예방의학회지, 35(1), pp.1~12 (2002), 대한예방의학회
- 백은정, "한국 성인남녀의 교육 수준과 비만 간 관계 : 연령에 따른 변화를 중심으로", 보건교육건강증진학회지, 30(5), pp.91~100 (2013), 한국보건교육건강증진학회
- Salbe AD, "Assessing risk factors for obesity between childhood and adolescence: II. energy metabolism and physical activity", Pediatrics, 110(2), pp.307~314 (2002)
- Matthews KA, "The relationship between psychological risk attributes and the metabolic syndrome in healthy women: Antecedent or consequence?", Metab Clin Exp, 51(12), pp.1573~1577 (2002)
- Stafford M, "Neighbourhood deprivation and health: Does it affect us all equally?", Int J Epidemiol, 32(3), pp.357~366 (2003)
- Janssen I, "Influence of individual- and area-level measures of socioeconomic status on obesity, unhealthy eating, and physical inactivity in canadian adolescents", Am J Clin Nutr, 83(1), pp.139~145 (2006)
- Gordon-Larsen P, "Inequality in the built environment underlies key health disparities in physical activity and obesity", Pediatrics, 117(2), pp.417~424 (2006)
- 박여린, "지역사회건강조사와 국민건강영양조사에 따른 우리나라 성인의 비만 및과체중 유병률 비교", Journal of Obesity & Metabolic Syndrome, 23(1), pp.64~68 (2014), 대한비만학회[DOI]
- Kim M, "A multilevel analysis on the association between socioeconomic factors and the metabolic syndrome", pp.2002
- "Ministry of Health and Welfare", ~
- The asia-pacific perspective: Redefining obesity and its treatment, "World Health Organization", ~ (2000)
- Townsend, P, "Health and deprivation: inequality and the North" (1988), Routledge
- Shin Y, "Cooperative System of Univ.Hanyang & Management Center for Health Promotion" (2009)
- 최민혁, "Deprivation and Mortality at the Town Level in Busan, Korea: An Ecological Study", 예방의학회지, 44(6), pp.242~248 (2011), 대한예방의학회
- Kawachi, I, "Neighborhoods and health" (2003), Oxford University Press
- Matozinhos FP, "Neighbourhood environments and obesity among adults: A multilevel analysis of an urban brazilian context", Preventive medicine reports, 2, pp.337~341 (2015)
- Larsen K, "Appropriate assessment of neighborhood effects on individual health: Integrating random and fixed effects in multilevel logistic regression", Am J Epidemiol, 161(1), pp.81~88 (2005)
- Sanagou M, "Hospital-level associations with 30-day patient mortality after cardiac surgery: A tutorial on the application and interpretation of marginal and multilevel logistic regression", BMC medical research methodology, 12(1), pp.1~ (2012)
- Wardle J, "Sex differences in the association of socioeconomic status with obesity", Am J Public Health, 92(8), pp.1299~1304 (2002)
- Paeratakul S, "The relation of gender, race and socioeconomic status to obesity and obesity comorbidities in a sample of US adults", Int J Obes Relat Metab Disord, 26(9), pp.1205~1210 (2002)
- Rissanen AM, "Determinants of weight gain and overweight in adult finns", Eur J Clin Nutr, 45(9), pp.419~430 (1991)
- Wamala SP, "Determinants of obesity in relation to socioeconomic status among middle-aged swedish women", Prev Med, 26(5), pp.734~744 (1997)
- Reither EN, "Do birth cohorts matter? age-period-cohort analyses of the obesity epidemic in the united states", Soc Sci Med, 69(10), pp.1439~1448 (2009)
- Brown AF, "Socioeconomic position and health among persons with diabetes mellitus: A conceptual framework and review of the literature", Epidemiol Rev, 26, pp.63~77 (2004)
- Woo J, "Influence of educational level and marital status on dietary intake, obesity and other cardiovascular risk factors in a hong kong chinese population", Eur J Clin Nutr, 53(6), pp.461~467 (1999)
- Sobal J, "Socioeconomic status and obesity: A review of the literature", Psychol Bull, 105(2), pp.260~ (1989)
- Wardle J, "Socioeconomic status and weight control practices in british adults", J Epidemiol Community Health, 55(3), pp.185~190 (2001)
- Villar JG, "Income and body mass index in europe", Economics & Human Biology, 7(1), pp.73~83 (2009)
- Rolls BJ, "Gender differences in eating behavior and body weight regulation", Health Psychology, 10(2), pp.133~ (1991)
- Gough B, "Barriers to healthy eating amongst men: A qualitative analysis", Soc Sci Med, 62(2), pp.387~395 (2006)
- Kennedy BP, "Income distribution, socioeconomic status, and self rated health in the united states: Multilevel analysis", BMJ, 317(7163), pp.917~921 (1998)
- 이경수, "대구·경북지역 고등학생의 조기흡연과 관련된 요인", 농촌의학.지역보건, 33(1), pp.90~100 (2008), 한국농촌의학.지역보건학회
- Rodin J., "Cultural and psychosocial determinants of weight concerns", Ann Intern Med, 119(7), pp.643~645 (1993)
- Song YM, "The accuracy of self-reported weight and height", Korean Journal of Epidemiology, 17(2), pp.257~268 (1995)