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Quantifying Neighbourhood Socioeconomic Effects in Clustering of Behaviour-Related Risk Factors: A Multilevel Analysis

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  • Jaana I Halonen
  • Mika Kivimäki
  • Jaana Pentti
  • Ichiro Kawachi
  • Marianna Virtanen
  • Pekka Martikainen
  • S V Subramanian
  • Jussi Vahtera

Abstract

Background: The extent to which neighbourhood characteristics explain accumulation of health behaviours is poorly understood. We examined whether neighbourhood disadvantage was associated with co-occurrence of behaviour-related risk factors, and how much of the neighbourhood differences in the co-occurrence can be explained by individual and neighbourhood level covariates. Methods: The study population consisted of 60 694 Finnish Public Sector Study participants in 2004 and 2008. Neighbourhood disadvantage was determined using small-area level information on household income, education attainment, and unemployment rate, and linked with individual data using Global Positioning System-coordinates. Associations between neighbourhood disadvantage and co-occurrence of three behaviour-related risk factors (smoking, heavy alcohol use, and physical inactivity), and the extent to which individual and neighbourhood level covariates explain neighbourhood differences in co-occurrence of risk factors were determined with multilevel cumulative logistic regression. Results: After adjusting for age, sex, marital status, and population density we found a dose-response relationship between neighbourhood disadvantage and co-occurrence of risk factors within each level of individual socioeconomic status. The cumulative odds ratios for the sum of health risks comparing the most to the least disadvantaged neighbourhoods ranged between 1.13 (95% confidence interval (CI): 1.03–1.24) and 1.75 (95% CI, 1.54–1.98). Individual socioeconomic characteristics explained 35%, and neighbourhood disadvantage and population density 17% of the neighbourhood differences in the co-occurrence of risk factors. Conclusions: Co-occurrence of poor health behaviours associated with neighbourhood disadvantage over and above individual's own socioeconomic status. Neighbourhood differences cannot be captured using individual socioeconomic factors alone, but neighbourhood level characteristics should also be considered.

Suggested Citation

  • Jaana I Halonen & Mika Kivimäki & Jaana Pentti & Ichiro Kawachi & Marianna Virtanen & Pekka Martikainen & S V Subramanian & Jussi Vahtera, 2012. "Quantifying Neighbourhood Socioeconomic Effects in Clustering of Behaviour-Related Risk Factors: A Multilevel Analysis," PLOS ONE, Public Library of Science, vol. 7(3), pages 1-8, March.
    • Handle: RePEc:plo:pone00:0032937
    DOI: 10.1371/journal.pone.0032937
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    References listed on IDEAS

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    1. Kivimäki, M. & Lawlor, D.A. & Smith, G.D. & Kouvonen, A. & Virtanen, M. & Elovainio, M. & Vahtera, J., 2007. "Socioeconomic position, co-occurrence of behavior-related risk factors, and coronary heart Disease: The finnish public sector study," American Journal of Public Health, American Public Health Association, vol. 97(5), pages 874-879.
    2. Virtanen, Marianna & Kivimäki, Mika & Kouvonen, Anne & Elovainio, Marko & Linna, Anne & Oksanen, Tuula & Vahtera, Jussi, 2007. "Average household income, crime, and smoking behaviour in a local area: The Finnish 10-Town study," Social Science & Medicine, Elsevier, vol. 64(9), pages 1904-1913, May.
    3. Poortinga, Wouter, 2006. "Perceptions of the environment, physical activity, and obesity," Social Science & Medicine, Elsevier, vol. 63(11), pages 2835-2846, December.
    4. Daniel Nettle, 2011. "Large Differences in Publicly Visible Health Behaviours across Two Neighbourhoods of the Same City," PLOS ONE, Public Library of Science, vol. 6(6), pages 1-5, June.
    5. Jokela, Markus & Kivimäki, Mika & Elovainio, Marko & Viikari, Jorma & Raitakari, Olli T. & Keltikangas-Järvinen, Liisa, 2009. "Urban/rural differences in body weight: Evidence for social selection and causation hypotheses in Finland," Social Science & Medicine, Elsevier, vol. 68(5), pages 867-875, March.
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    Cited by:

    1. Xiaochang Yan & Lu Chen & Hua Yan, 2019. "Socio-economic status, visual impairment and the mediating role of lifestyles in developed rural areas of China," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-18, April.
    2. Nasima Akhter & Ross Stewart Fairbairn & Mark Pearce & Jon Warren & Adetayo Kasim & Clare Bambra, 2021. "Local Inequalities in Health Behaviours: Longitudinal Findings from the Stockton-On-Tees Cohort Study," IJERPH, MDPI, vol. 18(21), pages 1-15, October.
    3. Win Wah & Arul Earnest & Charumathi Sabanayagam & Ching-Yu Cheng & Marcus Eng Hock Ong & Tien Y Wong & Ecosse L Lamoureux, 2015. "Composite Measures of Individual and Area-Level Socio-Economic Status Are Associated with Visual Impairment in Singapore," PLOS ONE, Public Library of Science, vol. 10(11), pages 1-12, November.
    4. Namin, S. & Zhou, Y. & Neuner, J. & Beyer, K., 2021. "The role of residential history in cancer research: A scoping review," Social Science & Medicine, Elsevier, vol. 270(C).
    5. Xiaoqi Feng & Thomas Astell-Burt, 2013. "Neighborhood Socioeconomic Circumstances and the Co-Occurrence of Unhealthy Lifestyles: Evidence from 206,457 Australians in the 45 and Up Study," PLOS ONE, Public Library of Science, vol. 8(8), pages 1-7, August.
    6. Carri L Hand & Bret T Howrey, 2019. "Associations Among Neighborhood Characteristics, Mobility Limitation, and Social Participation in Late Life," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 74(3), pages 546-555.
    7. Tuula Oksanen & Ichiro Kawachi & Anne Kouvonen & Soshi Takao & Etsuji Suzuki & Marianna Virtanen & Jaana Pentti & Mika Kivimäki & Jussi Vahtera, 2013. "Workplace Determinants of Social Capital: Cross-Sectional and Longitudinal Evidence from a Finnish Cohort Study," PLOS ONE, Public Library of Science, vol. 8(6), pages 1-7, June.
    8. Jimenez, Marcia P. & Wellenius, Gregory A. & Subramanian, S.V. & Buka, Stephen & Eaton, Charles & Gilman, Stephen E. & Loucks, Eric B., 2019. "Longitudinal associations of neighborhood socioeconomic status with cardiovascular risk factors: A 46-year follow-up study," Social Science & Medicine, Elsevier, vol. 241(C).

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