Associations between obesity and neighborhood socioeconomic status: Variations by gender and family income status

Objectives: To analyze if the association between obesity and neighborhood socioeconomic status (SES) was moderated by gender and family income. Methods: Data from 19,448 individuals 18 and older from the 2001-2008 National Health and Nutrition Examination Survey (NHANES) were geo-matched with social and built environment characteristics from the 2000 Census and other data sources. Objective height and weight measures were used to create body mass index (BMI) and obese status (BMI >= 30). Tracts were divided into four quartiles using a composite factor score capturing neighborhood SES. Individuals were divided into four income groups by the income-to-poverty ratio (I/P). Multilevel regression analyses were performed. Results: The association between neighborhood SES and obesity/BMI was more consistently significant among higher-income women than lower-income women. The same association was not found for men. Neighborhood built environment factors did not mediate the relationship between neighborhood SES and individual weight outcome. Conclusions: Neighborhood SES had stronger and more consistent associations with obesity and BMI for women than men, and for higher-income women than lower-income women.