Are Associations Between Neighborhood Socioeconomic Characteristics and Body Mass Index or Waist Circumference Based on Model Extrapolations?

Abstract : Background: We investigated whether neighborhood socioeconomic characteristics, measured within person-centered areas (ie, centered on individuals' residences) are associated with body mass index (BMI [kg/m 2]) and waist circumference. We used propensityscore matching as a diagnostic and validation tool to examine whether socio-spatial segregation (and related structural confounding) allowed us to estimate neighborhood socioeconomic effects adjusted for individual socioeconomic characteristics without excessive model extrapolations. Methods: Using the RECORD (Residential Environment and CORonary heart Disease) Cohort Study, we conducted cross-sectional analyses of 7230 adults from the Paris region. We first estimated the relationships of 3 neighborhood socioeconomic indicators (education, income, real estate prices) with BMI and waist circumference using traditional multilevel regression models adjusted for individual covariates. Second, we examined whether these associations persisted when estimated among participants exchangeable based on their probability of living in low-socioeconomic-status neighborhoods (propensity-score matched samples). Copyright © 2011 by Lippincott Williams & Wilkins.