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Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area
Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Carolina Population Center, University of North Carolina at Chapel Hill, 104 CPC South, Chapel Hill, NC 27516, USA
Sansom Institute for Health Research, The University of South Australia, Adelaide, SA 5001, Australia
Axe santé des populations, CRCHUM (Centre de recherche du Centre hospitalier de l’Université de Montréal), Montréal, Québec H2W 1V1, Canada
Département de médecine sociale et préventive, Université de Montréal, Montréal, Québec H3C 3J7, Canada
* Author to whom correspondence should be addressed.
Received: 26 October 2009; Accepted: 1 December 2009 / Published: 4 December 2009
Abstract: Introduction: Cardiovascular Disease (CVD) has been linked to \"neighbourhood\" socioeconomic status (nSES), often operationalized as a composite index of aggregate income, occupation and education within predefined administrative boundaries. The role of specific, non-composite socioeconomic markers has not been clearly explained. It is also unclear whether the relationship between nSES and CVD varies according to sex. We sought to determine whether area-level unemployment (ALU) was associated with CVD risk, and whether this association differed by sex. Methods: 342 individuals from the Montreal Neighbourhood Survey of Lifestyle and Health provided self-reported behavioural and socioeconomic information. A nurse collected biochemical and anthropometric data. ALU, a weighted average of the proportion of persons 15-years and older available for but without work, was measured using a Geographic Information System for a 250 m buffer centred on individual residence. Generalized Estimating Equations were used to estimate the associations between ALU, body mass index (BMI) and a cumulative score for total cardiometabolic risk (TCR). Results: After confounder adjustments, the mean 4th minus 1st quartile difference in BMI was 3.19 kg/m2 (95% CI: 2.39, 3.99), while the prevalence ratio for the 4th relative to 1st quartile for TCR was 2.20 (95 % CI: 1.53, 3.17). Sex interacted with ALU; women relative to men had greater mean 3.97 kg/m2 (95% CI: 2.08, 5.85) BMI and greater mean TCR 1.51 (95% CI: 0.78, 2.90), contrasted at mean ALU. Conclusions: Area-level unemployment is associated with greater CVD risk, and this association is stronger for women.
Keywords: neighbourhood; unemployment; cardiovascular diseases; residence characteristics
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Naimi, A.I.; Paquet, C.; Gauvin, L.; Daniel, M. Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area. Int. J. Environ. Res. Public Health 2009, 6, 3082-3096.
Naimi AI, Paquet C, Gauvin L, Daniel M. Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area. International Journal of Environmental Research and Public Health. 2009; 6(12):3082-3096.
Naimi, Ashley Isaac; Paquet, Catherine; Gauvin, Lise; Daniel, Mark. 2009. "Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area." Int. J. Environ. Res. Public Health 6, no. 12: 3082-3096.