Psychosocial environment: definitions, measures and associations with weight status – a systematic review

Abstract

SummarySocio-ecological models suggest that many elements of the social environment act as upstream determinants of obesity. This systematic review examined definitions, measures and strength of associations between the psychosocial environment and adult weight status. Studies were included if they were conducted on adults, the outcome was weight status, carried out in any developed country and investigated at least one psychosocial environmental construct. Six databases for primary studies were searched: EMBASE, MEDLINE, PsycINFO, Scopus, Web of Science and the Cochrane Library. We restricted our search to studies published in English between January 1995 and February 2015. An adapted 'Quality Assessment Tool for Quantitative Studies' was used to evaluate risk of bias of included studies. Out of 14,784 screened records, 42 articles were assessed using full text. A total of 19 studies were included. The strongest associations with weight status were found for social capital and collective efficacy, although few studies found significant associations. There was heterogeneity in the definitions and metrics of psychosocial environmental constructs. There is limited evidence that greater social capital and collective efficacy are associated with healthier weight status. The research conducted to date has not robustly identified relations. We highlight challenges to undertaking research and establishing causality in this field and provide recommendations for further research.

Neighbourhood social capital and obesity: a systematic review of the literature

“…In a European setting, Mackenbach et al . reported that both social cohesion and social network were associated with lower odds of being obese (not so clear in the case of overweight) . Cohen et al .…”

“…This is, to our knowledge, the first systematic review on social capital and obesity conducted from a social capital theory perspective. In 2016, Glonti et al published in this journal a systematic review on the psychosocial determinants of obesity, which included studies that reported a relationship between adult weight status and five psychosocial environmental constructs: collective efficacy, social cohesion, social capital and social support (45). From a social capital theory approach, as described in the introduction of this paper, all these constructs comprise different dimensions of social capital and, in fact, some of the papers reviewed by Glonti (56).…”

“…In a European setting, Mackenbach et al reported that both social cohesion and social network were associated with lower odds of being obese (not so clear in the case of overweight) (45). Cohen et al is the only study taking collective efficacy as indicator of social capital, and it suggested a protective effect on obesity (41).…”

The Upstream Determinants of Adult Obesity

“…Explanations of the perceived effect of social networks include social contagion (whereby the network influences obesity-related behaviours via modelling), social capital (whereby a sense of belonging and social support influence obesity-related behaviours) and social selection (whereby an individual's network is a function of their weight) [29]. In a recent systematic review, we showed that the strongest social environmental correlates of obesity were, indeed, social capital and collective efficacy, but, in general, few social environmental factors were consistently related to adult obesity [30]. …”

The way ahead: where next for research into obesogenic environments?

“…Moreover, the European context provided a valuable added dimension as a result of both the differences between the countries in which the research took place and their similarities. The systematic reviews on the built and social environment demonstrated the heterogeneity within the existing literature. A systematic review of virtual audit tools demonstrated the feasibility and reliability of using this novel approach for assessing the built environment .…”