Elsevier

Social Science & Medicine

Volume 195, December 2017, Pages 17-24
Social Science & Medicine

The joint effects of family risk of obesity and neighborhood environment on obesity among women

https://doi.org/10.1016/j.socscimed.2017.10.018Get rights and content

Highlights

  • We focus on combinations of familial susceptibility and neighborhood walkability.

  • The comparison group is women with lean family BMI and more walkable neighborhoods.

  • Women in the other three combinations show greater risks of obesity.

  • Neighborhoods are associated with obesity among women with high family obesity risk.

  • This association is even stronger for women with a lower family risk of obesity.

Abstract

Obesity is a significant health problem in the United States that has encouraged a search for modifiable risk factors, such as walkable neighborhood designs. Prior research has shown linkages between a family history of obesity (i.e., due to either genetic or non-genetic factors) and an individual's risk of elevated body mass index (BMI). Yet, we know little about the possible interactions between neighborhood walkability and family susceptibility to unhealthy BMI in predicting individual BMI. This paper addresses this important research gap using a sample of 9918 women, derived from vital and administrative data in the Utah Population Database. We use a novel indicator of familial risk (a summary measure of siblings' BMI) and a neighborhood walkability score to capture familial susceptibility and environmental exposures, respectively. The analysis focuses on distinct risk combinations of familial susceptibility and neighborhood walkability. Compared with the “best” combination of lean family BMI history and more walkable neighborhoods, women in all of the other three family weight history/neighborhood categories show greater risks of obesity. Our results also indicate that the neighborhood environment has a strong association with individual obesity among women with higher family risk of obesity but that the association between neighborhood environment and individual obesity is even stronger for women with a lower family risk of obesity.

Section snippets

Background

A social ecological approach to chronic disease and health outcomes guides our understanding of obesity risk by identifying many potential factors that contribute to unhealthy weight (Bronfenbrenner & Ceci, 1994). Biological, genetic and social factors present throughout the life course independently, cumulatively, and interactively may affect obesity risk (Kuh et al., 2003). In the past decade, a large body of work on such gene-environment (GxE) interaction has emerged to investigate the

Data and methods

The data for our analysis are derived from women living in Salt Lake County, Utah who had a live birth between 1995 and 2005. Salt Lake County is an advantageous setting for this study for three reasons. First, it is an urban county containing 567 census block groups that vary in terms of walkability features. Second, Utahns’ average household size and total fertility rate have both been above the national average for more than 50 years (Kem, 2016, Sturgill and Heaton, 2006). This means that

Results

Descriptive statistics are presented in Table 1. The average BMI among these women is 24 and their average age is 28. Approximately 14% are obese based on the cut-points as defined by the Centers for Disease Control classification. This is somewhat less than estimates of obesity among adult women of all ages in national data sources such as the National Health and Nutrition Examination Survey (Ogden et al., 2014). But, it is closer to the overall adult obesity rate in Utah in 2000 which was

Discussion

The aim of this paper was to consider potential interactive relationships between a familial susceptibility for high BMI and neighborhood walkability. A social ecological perspective leads us to consider how family background and social factors interact to influence body weight of women. Family background might predispose women to have a higher obesity risk in adulthood but neighborhood environment might have the ability to attenuate the potential deleterious effects of such family risk

References (62)

  • J. Baird et al.

    Being big or growing fast: systematic review of size and growth in infancy and later obesity

    Br. Med. J.

    (2005)
  • P. Bearman

    Introduction: Exploring genetics and social structure

    Am. J. Sociol.

    (2008)
  • T.R. Berry et al.

    Changes in BMI over 6 years: the role of demographic and neighborhood characteristics

    Int. J. Obes.

    (2010)
  • G.S. Bieler et al.

    Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data

    Am. J. Epidemiol.

    (2010)
  • J.D. Boardman et al.

    Defining the environment in gene-environment research: lessons from social epidemiology

    Am. J. Public Health

    (2013)
  • J.D. Boardman et al.

    Gene-environment interactions related to body mass: school policies and social context as environmental moderators

    J. Theor. Polit.

    (2012)
  • T.D. Brisbois et al.

    Early markers of adult obesity: a review

    Obes. Rev.

    (2012)
  • U. Bronfenbrenner et al.

    Nature-nurture reconceptualized in developmental perspective: a bioecological model

    Psychol. Rev.

    (1994)
  • N.A. Christakis et al.

    The spread of obesity in a large social network over 32 years

    New England J. Med.

    (2007)
  • J.A. Cornicelli

    Gene–environment interactions in obesity

  • A.W. Drong et al.

    The genetic and epigenetic basis of type 2 diabetes and obesity

    Clin. Pharmacol. Ther.

    (2012)
  • C.E. Elks et al.

    Variability in the heritability of body mass index: a systematic review and meta-regression

    Front. Endocrinol. (Lausanne)

    (2012)
  • T.M. Frayling et al.

    A common variant in the FTO gene is associated with body mass index and predisposes to childhood and adult obesity

    Science

    (2007)
  • M.W. Gillman et al.

    Maternal gestational diabetes, birth weight, and adolescent obesity

    Pediatrics

    (2003)
  • G. Grasser et al.

    Objectively measured walkability and active transport and weight-related outcomes in adults: a systematic review

    Int. J. Public Health

    (2013)
  • E.P. Gunderson et al.

    Epidemiology of gestational weight gain and body weight changes after pregnancy

    Epidemiol. Rev.

    (2000)
  • T. Harder et al.

    Duration of breastfeeding and risk of overweight: a meta-analysis

    Am. J. Epidemiol.

    (2005)
  • M.M. Hetherington et al.

    Gene-environment interactions in obesity

    (2010)
  • J.O. Hill et al.

    Obesity and the environment: where do we go from here?

    Science

    (2003)
  • T.A. Hillier et al.

    Childhood obesity and metabolic imprinting: the ongoing effects of maternal hyperglycemia

    Diabetes Care

    (2007)
  • J.A. Hirsch et al.

    Change in walking and body mass index following residential relocation: the multi-ethnic study of atherosclerosis

    Am. J. Public Health

    (2014)
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