Neighborhood deprivation, built environment, and childhood obesity in the city of Oslo

Abstract

Background Even though the social and built environment characteristics of neighborhoods have been studied as potential determinants of social inequalities in obesity among adults, fewer studies have focused on children. Our first aim was to investigate whether there were differences in the food and physical activity environments between different neighborhood deprivation levels in the city of Oslo. We also explored whether there was an association between overweight/obesity prevalence among adolescents and i. neighborhood deprivation levels and ii. food and physical activity environments of the neighborhoods they live in. Methods We conducted a food and physical activity environment mapping (using ArcGIS Pro) in all neighborhoods of Oslo, which were defined by administrative boundaries (sub-districts). The neighborhood deprivation score was calculated based on the percentage of households living in poverty, unemployment in the neighborhood, and residents with low education. A cross-sectional study including 802 seventh graders from 28 primary schools in Oslo residing in 75 out of 97 sub-districts in Oslo was also performed. MANCOVA and partial correlations were ran to compare the built environment distribution between different neighborhood deprivation levels, and multilevel logistic regression analyses were used to explore the effect of neighborhood deprivation and the food and physical activity environments on childhood overweight/obesity. Results We found that deprived neighborhoods had greater availability of fast food restaurants and fewer indoor recreational facilities compared to low-deprived neighborhoods. Additionally, we observed that the residential neighborhoods of the children with overweight/obesity had greater availability of grocery and convenience stores when compared to the residential neighborhoods of the children without overweight/obesity. Children living in deprived neighborhoods had a two-fold higher odds (95% CI = 1.1–3.8) to have overweight/obesity compared to children living in low-deprived neighborhoods, regardless of participants' ethnicity and parental education. However, the built environment did not determine the relationship between neighborhood deprivation and children’s overweight/obesity. Conclusions The neighborhoods in Oslo with higher deprivation levels had more obesogenic characteristics than the low-deprived neighborhoods. Children living in high-deprived neighborhoods were more likely to have overweight/obesity than their counterparts from low-deprived neighborhoods. Thus, preventive measures targeting children from low-deprived neighborhoods should be put in place in order to reduce incidence of overweight/obesity.

Social and environmental stressors of cardiometabolic health

“…At the same time, lower education may be reflected in reduced knowledge-related skills and limited health literacy 46 , which all together again trigger unhealthy behaviours. Additionally, according to the previous studies, disadvantaged populations live in less prestigious neighbourhoods with limited resources that may be reflected for instance in lower availability of sport facilities and greenspaces [47][48][49] , increased exposure to unhealthy diet options 47,[50][51][52][53] and higher environmental pollution 15 . Therefore, we can assume that unhealthy behaviour as cardiometabolic risk factors arise from socio-economic disadvantage and at the same time, behavioural response may partially explain social inequalities in cardiometabolic health.…”