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Collective efficacy and obesity: The potential influence of social factors on health


  • Cohen, Deborah A.
  • Finch, Brian K.
  • Bower, Aimee
  • Sastry, Narayan


Social determinants have been identified as a fundamental cause of health and disease in most industrialized countries. However, much less is known about which characteristics of communities may lead to disparities in health outcomes. Collective efficacy--the willingness of community members to look out for each other and intervene when trouble arises--is a social factor shown to be associated with outcomes related to obesity, including premature mortality and cardiovascular disease. The objective of this study is to determine whether neighborhood collective efficacy is associated with individual measures of body mass index (BMI) in adolescents. We use a multi-level, cross-sectional survey in Los Angeles County, involving 807 adolescents in 684 households in 65 neighborhoods in addition to a sample of 3000 adult respondents. The main outcomes measures are BMI, at risk of overweight, and overweight status. Using a two-level model, we find significant relationships between collective efficacy and all three outcomes, net of levels of neighborhood disadvantage. The associations between BMI and collective efficacy could potentially be explained by several factors, including a metabolic pathway, neighborhood differences in the physical and social environments, or a combination of these two. If group-level collective efficacy is indeed important in the regulation of individual-level net energy balance, it suggests that future interventions to control weight by addressing the social environment at the community level may be promising.

Suggested Citation

  • Cohen, Deborah A. & Finch, Brian K. & Bower, Aimee & Sastry, Narayan, 2006. "Collective efficacy and obesity: The potential influence of social factors on health," Social Science & Medicine, Elsevier, vol. 62(3), pages 769-778, February.
  • Handle: RePEc:eee:socmed:v:62:y:2006:i:3:p:769-778

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    References listed on IDEAS

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    2. Lochner, Kimberly A. & Kawachi, Ichiro & Brennan, Robert T. & Buka, Stephen L., 2003. "Social capital and neighborhood mortality rates in Chicago," Social Science & Medicine, Elsevier, vol. 56(8), pages 1797-1805, April.
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    Cited by:

    1. Cradock, Angie L. & Kawachi, Ichiro & Colditz, Graham A. & Gortmaker, Steven L. & Buka, Stephen L., 2009. "Neighborhood social cohesion and youth participation in physical activity in Chicago," Social Science & Medicine, Elsevier, vol. 68(3), pages 427-435, February.
    2. Litt, J.S. & Schmiege, S.J. & Hale, J.W. & Buchenau, M. & Sancar, F., 2015. "Exploring ecological, emotional and social levers of self-rated health for urban gardeners and non-gardeners: A path analysis," Social Science & Medicine, Elsevier, vol. 144(C), pages 1-8.
    3. repec:pri:crcwel:wp10-04-ff is not listed on IDEAS
    4. Burdette, Amy M. & Hill, Terrence D., 2008. "An examination of processes linking perceived neighborhood disorder and obesity," Social Science & Medicine, Elsevier, vol. 67(1), pages 38-46, July.
    5. Harrington, Daniel W. & Elliott, Susan J., 2009. "Weighing the importance of neighbourhood: A multilevel exploration of the determinants of overweight and obesity," Social Science & Medicine, Elsevier, vol. 68(4), pages 593-600, February.
    6. Sharp, Gregory & Denney, Justin T. & Kimbro, Rachel T., 2015. "Multiple contexts of exposure: Activity spaces, residential neighborhoods, and self-rated health," Social Science & Medicine, Elsevier, vol. 146(C), pages 204-213.
    7. Poortinga, Wouter, 2006. "Perceptions of the environment, physical activity, and obesity," Social Science & Medicine, Elsevier, vol. 63(11), pages 2835-2846, December.
    8. Rachel Tolbert Kimbro & Jeanne Brooks-Gunn & Sara McLanahan, 2010. "Neighborhood Context, Poverty, and Urban Children's Outdoor Play," Working Papers 1226, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Research on Child Wellbeing..
    9. Ullmann, S. Heidi & Goldman, Noreen & Pebley, Anne R., 2013. "Contextual factors and weight change over time: A comparison between U.S. Hispanics and other population sub-groups," Social Science & Medicine, Elsevier, vol. 90(C), pages 40-48.
    10. Brañas-Garza, Pablo & Espín, Antonio M. & Lenkei, Balint, 2015. "BMI is not related to altruism, fairness, trust or reciprocity: Experimental evidence from the field and the lab," MPRA Paper 68184, University Library of Munich, Germany.
    11. Hale, James & Knapp, Corrine & Bardwell, Lisa & Buchenau, Michael & Marshall, Julie & Sancar, Fahriye & Litt, Jill S., 2011. "Connecting food environments and health through the relational nature of aesthetics: Gaining insight through the community gardening experience," Social Science & Medicine, Elsevier, vol. 72(11), pages 1853-1863, June.
    12. Bjornstrom, Eileen E.S., 2011. "The neighborhood context of relative position, trust, and self-rated health," Social Science & Medicine, Elsevier, vol. 73(1), pages 42-49, July.
    13. Alfonso, Moya L. & Nickelson, Jen & Hogeboom, David L. & French, Jennifer & Bryant, Carol A. & McDermott, Robert J. & Baldwin, Julie A., 2008. "Assessing local capacity for health intervention," Evaluation and Program Planning, Elsevier, vol. 31(2), pages 145-159, May.
    14. Lei, Lei, 2017. "The impact of community context on children's health and nutritional status in China," Social Science & Medicine, Elsevier, vol. 179(C), pages 172-181.
    15. Zick, Cathleen D. & Smith, Ken R. & Fan, Jessie X. & Brown, Barbara B. & Yamada, Ikuho & Kowaleski-Jones, Lori, 2009. "Running to the Store? The relationship between neighborhood environments and the risk of obesity," Social Science & Medicine, Elsevier, vol. 69(10), pages 1493-1500, November.
    16. Gaur, Kirti & Keshri, Kunal & Joe, William, 2013. "Does living in slums or non-slums influence women's nutritional status? Evidence from Indian mega-cities," Social Science & Medicine, Elsevier, vol. 77(C), pages 137-146.
    17. Brent Berry & Taralyn McMullen, 2008. "Visual communication to children in the supermarket context: Health protective or exploitive?," Agriculture and Human Values, Springer;The Agriculture, Food, & Human Values Society (AFHVS), vol. 25(3), pages 333-348, September.
    18. repec:eee:jcjust:v:50:y:2017:i:c:p:29-41 is not listed on IDEAS
    19. Renna, Francesco & Grafova, Irina B. & Thakur, Nidhi, 2008. "The effect of friends on adolescent body weight," Economics & Human Biology, Elsevier, vol. 6(3), pages 377-387, December.
    20. Stafford, Mai & Cummins, Steven & Ellaway, Anne & Sacker, Amanda & Wiggins, Richard D. & Macintyre, Sally, 2007. "Pathways to obesity: Identifying local, modifiable determinants of physical activity and diet," Social Science & Medicine, Elsevier, vol. 65(9), pages 1882-1897, November.
    21. Santana, Paula & Santos, Rita & Nogueira, Helena, 2009. "The link between local environment and obesity: A multilevel analysis in the Lisbon Metropolitan Area, Portugal," Social Science & Medicine, Elsevier, vol. 68(4), pages 601-609, February.
    22. Kim, Daniel & Subramanian, S.V. & Gortmaker, Steven L. & Kawachi, Ichiro, 2006. "US state- and county-level social capital in relation to obesity and physical inactivity: A multilevel, multivariable analysis," Social Science & Medicine, Elsevier, vol. 63(4), pages 1045-1059, August.


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