title: Impact of cumulative area-based adverse socioeconomic environment on body mass index and overweight.
abstract: OBJECTIVE
  Although the relationship between area socioeconomic environment and obesity is known, previous research has measured area socioeconomic environment at only one point in time. This study evaluates the relationship of cumulative area-based adverse socioeconomic environment with body mass index (BMI) and overweight.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Spain.
  
  
  METHODS
  17 917 subjects in 2001.
  
  
  METHODS
  Information from 1980, 1990 and 2000 was used for the percentage of the population with low educational achievement, gross domestic product per capita (GDPpc), and Gini coefficient to estimate BMI and prevalence of overweight by the number of times each province had an adverse exposure to each of these measures of socioeconomic environment.
  
  
  RESULTS
  After adjusting for individual variables and sports facilities in the area, the difference in BMI in residents of provinces with the highest percentage of population with low educational achievement in 1980, 1990 and 2000, compared with residents of provinces with no history of adverse socioeconomic environment based on this indicator, was 0.61 kg/m(2), whereas the prevalence of overweight was 1.46 times higher. Similar results were obtained for residents of provinces with cumulative low GDPpc versus residents of provinces that had never had low GDPpc. Neither BMI nor overweight were associated with cumulative income inequality based on the Gini coefficient.
  
  
  CONCLUSIONS
  Cumulative adverse socioeconomic environment based on indicators of educational level or wealth, but not of income inequality, is positively associated with BMI and overweight. This association is not explained by individual characteristics or by the availability of sports facilities.
authors.affiliation: Department of Preventive Medicine and Public Health, Faculty of Medicine, Universidad Complutense de Madrid, Ciudad Universitaria, 28040 Madrid, Spain. enriqueregidor@hotmail.com
authors.forename: E
authors.initials: E
authors.lastname: Regidor
authors.forename: J L
authors.initials: JL
authors.lastname: Gutiérrez-Fisac
authors.forename: E
authors.initials: E
authors.lastname: Ronda
authors.forename: M E
authors.initials: ME
authors.lastname: Calle
authors.forename: D
authors.initials: D
authors.lastname: Martínez
authors.forename: V
authors.initials: V
authors.lastname: Domínguez
mesh_terms: D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D004522:Educational Status; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D012931:Social Environment; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D013177:Sports / Q000706:statistics & numerical data