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Associations between area socioeconomic status, individual mental health, physical activity, diet and change in cardiometabolic risk amongst a cohort of Australian adults: A longitudinal path analysis

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  • Suzanne J Carroll
  • Michael J Dale
  • Theophile Niyonsenga
  • Anne W Taylor
  • Mark Daniel

Abstract

Presumed pathways from environments to cardiometabolic risk largely implicate health behaviour although mental health may play a role. Few studies assess relationships between these factors. This study estimated associations between area socioeconomic status (SES), mental health, diet, physical activity, and 10-year change in glycosylated haemoglobin (HbA1c), comparing two proposed path structures: 1) mental health and behaviour functioning as parallel mediators between area SES and HbA1c; and 2) a sequential structure where mental health influences behaviour and consequently HbA1c. Three waves (10 years) of population-based biomedical cohort data were spatially linked to census data based on participant residential address. Area SES was expressed at baseline using an established index (SEIFA-IEO). Individual behavioural and mental health information (Wave 2) included diet (fruit and vegetable servings per day), physical activity (meets/does not meet recommendations), and the mental health component score of the 36-item Short Form Health Survey. HbA1c was measured at each wave. Latent variable growth models with a structural equation modelling approach estimated associations within both parallel and sequential path structures. Models were adjusted for age, sex, employment status, marital status, education, and smoking. The sequential path model best fit the data. HbA1c worsened over time. Greater area SES was statistically significantly associated with greater fruit intake, meeting physical activity recommendations, and had a protective effect against increasing HbA1c directly and indirectly through physical activity behaviour. Positive mental health was statistically significantly associated with greater fruit and vegetable intakes and was indirectly protective against increasing HbA1c through physical activity. Greater SES was protective against increasing HbA1c. This relationship was partially mediated by physical activity but not diet. A protective effect of mental health was exerted through physical activity. Public health interventions should ensure individuals residing in low SES areas, and those with poorer mental health are supported in meeting physical activity recommendations.

Suggested Citation

  • Suzanne J Carroll & Michael J Dale & Theophile Niyonsenga & Anne W Taylor & Mark Daniel, 2020. "Associations between area socioeconomic status, individual mental health, physical activity, diet and change in cardiometabolic risk amongst a cohort of Australian adults: A longitudinal path analysis," PLOS ONE, Public Library of Science, vol. 15(5), pages 1-16, May.
    • Handle: RePEc:plo:pone00:0233793
    DOI: 10.1371/journal.pone.0233793
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    1. Steffen Andreas Schüle & Gabriele Bolte, 2015. "Interactive and Independent Associations between the Socioeconomic and Objective Built Environment on the Neighbourhood Level and Individual Health: A Systematic Review of Multilevel Studies," PLOS ONE, Public Library of Science, vol. 10(4), pages 1-31, April.
    2. Murray Aitkin, 1999. "A General Maximum Likelihood Analysis of Variance Components in Generalized Linear Models," Biometrics, The International Biometric Society, vol. 55(1), pages 117-128, March.
    3. Badland, Hannah & Whitzman, Carolyn & Lowe, Melanie & Davern, Melanie & Aye, Lu & Butterworth, Iain & Hes, Dominique & Giles-Corti, Billie, 2014. "Urban liveability: Emerging lessons from Australia for exploring the potential for indicators to measure the social determinants of health," Social Science & Medicine, Elsevier, vol. 111(C), pages 64-73.
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    1. Bridget Allen & Karla Canuto & John Robert Evans & Ebony Lewis & Josephine Gwynn & Kylie Radford & Kim Delbaere & Justin Richards & Nigel Lovell & Michelle Dickson & Rona Macniven, 2021. "Facilitators and Barriers to Physical Activity and Sport Participation Experienced by Aboriginal and Torres Strait Islander Adults: A Mixed Method Review," IJERPH, MDPI, vol. 18(18), pages 1-28, September.

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