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Interplay of socioeconomic status and supermarket distance is associated with excess obesity risk: a UK cross-sectional study

Published version
Peer-reviewed

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Authors

Burgoine, THS 
Mackenbach, JD 
Lakerveld, J 
Forouhi, NG 
Griffin, SJ 

Abstract

US policy initiatives have sought to improve health through attracting neighborhood supermarket investment. Little evidence exists to suggest these policies will be effective, in particular where there are socioeconomic barriers to healthy eating. We measured the independent associations and combined interplay of supermarket access and socioeconomic status with obesity. Using data on 9,702 UK adults, we employed adjusted regression analyses to estimate measured BMI (kg/m2), overweight (25≥BMI<30) and obesity (≥30), across participants’ highest educational attainment (three groups) and tertiles of street network distance (km) from home location to nearest supermarket. Jointly-classified models estimated combined associations of education and supermarket distance, and relative excess risk due to interaction (RERI). Participants farthest away from their nearest supermarket had higher odds of obesity (OR, 95% CI: 1.33, 1.11-1.58), relative to those living closest. Lower education was also associated with higher odds of obesity. Those least-educated and living farthest away had 3.39 (2.46-4.65) times the odds of being obese of those highest-educated and living closest, with an excess obesity risk (RERI=0.09); results were similar for overweight. Our results suggest that public health can be improved through planning better access to supermarkets, in combination with interventions to address socioeconomic barriers.

Description

Keywords

body mass index, distance, education, interaction, obesity, supermarkets, Adult, Body Weight, Cross-Sectional Studies, England, Female, Food Supply, Geography, Humans, Male, Middle Aged, Obesity, Overweight, Risk Factors, Social Class

Journal Title

International Journal of Environmental Research and Public Health

Conference Name

Journal ISSN

1661-7827
1660-4601

Volume Title

14

Publisher

MDPI AG
Sponsorship
Medical Research Council (MC_UU_12015/1)
Medical Research Council (MC_UU_12015/5)
Medical Research Council (MR/K023187/1)
MRC (MR/L501438/1)
Economic and Social Research Council (ES/G007462/1)
Wellcome Trust (087636/Z/08/Z)
Medical Research Council (MC_UU_12015/4)
Medical Research Council (MC_UU_12015/3)
Medical Research Council (MC_U106179473)
This work was supported by the Centre for Diet and Activity Research (CEDAR), a UK Clinical Research Collaboration (UKCRC) Public Health Research Centre of Excellence. Funding from the British Heart Foundation, Cancer Research UK, Economic and Social Research Council, Medical Research Council, the National Institute for Health Research (grant number ES/G007462/1), and the Wellcome Trust (grant number 087636/Z/08/Z), under the auspices of the UK Clinical Research Collaboration, is gratefully acknowledged. The Fenland Study is funded by the MRC and the study PIs acknowledge support from MC_UU_12015/1 and MC_UU_12015/5. Pablo Monsivais also received support from the Health Equity Research Collaborative, a Grand Challenge Research Initiative of Washington State University.