Understanding the individual and socio-environmental risk factors of overweight and obesity in Ontario: a multilevel analysis

Abstract

<p>Over the last several decades, overweight and obesity have reached epidemic proportions in many developing countries, including Canada. These conditions have been identified as major risk factors for chronic disease and disability in many different contexts. Further, overweight and obesity have become a public health problem in and of themselves. The various symptoms and co-morbidities associated with these chronic conditions place a great deal of stress on the Canadian health care system, generating great economic concern.</p> <p>This research takes a population health approach to the study of obesity, examining the complex relationships between individual behaviours and characteristics, human biology, and aspects of the local social and physical environment. To achieve these ends, a subset of the national Canadian Heart Health Surveys (CHHS, 1986-1992) specific to the province of Ontario was linked to neighbourhood-level data from the 1991 Canadian Census. Following this linkage multilevel analyses were applied to these hierarchical data. Preliminary findings indicate substantial area-level variation in body mass index (BMI) and waist circumference (WC), and an important role for neighbourhood level variables even after adjustment for individual demographic, socioeconomic, and behavioural characteristics.</p> <p>For example, living in areas with lower average dwelling values was associated with a higher BMI (2.728 kg/m²) for women in comparison to areas with a high average dwelling value. These findings provide evidence that the underlying mechanism driving the increasing prevalence of overweight and obesity may be an environment that promotes high risk behaviours and lifestyles. The findings from this study provide support to the notion that at-risk individuals and at-risk neighbourhoods (low socioeconomic status) should both be targeted when designing and implementing health promotion policy.</p>