title: The Interaction Between an Individual's Acculturation and Community Factors on Physical Inactivity and Obesity: A Multilevel Analysis.
abstract: OBJECTIVE
  We examined whether the interactions between primarily speaking English at home and community-level measures (median household income and immigrant composition) are associated with physical inactivity and obesity.
  
  
  METHODS
  We pooled the 2005 and 2007 Los Angeles County Health Survey data to construct a multilevel data set, with community-level median household income and immigrant density as predictors at the community level. After controlling for individual-level demographic variables, we included the respondent's perceived community safety as a covariate to test the hypothesis that perceived public safety mediates the association between acculturation and health outcomes.
  
  
  RESULTS
  The interaction between community median household income and primarily speaking English at home was associated with lower likelihoods of physical inactivity (odds ratio [OR] = 0.644; 95% confidence interval [CI] = 0.502, 0.825) and obesity (OR = 0.674; 95% CI = 0.514, 0.882). These odds remained significant after we controlled for perceived community safety.
  
  
  CONCLUSIONS
  Resources in higher-income areas may be beneficial only to residents fully integrated into the community. Future research could focus on understanding how linguistic isolation affects community-level social learning and access to resources and whether this differs by family-level acculturation.
authors.affiliation: Lu Shi is with the Department of Public Health Science, Clemson University, Clemson, SC. Donglan Zhang, Jeroen van Meijgaard, and Jonathan E. Fielding are with the Center for Health Advancement, Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles. Kara E. MacLeod is with the Institute for Health Promotion and Disease Prevention Research, Keck School of Medicine, University of Southern California, Los Angeles.
authors.forename: Lu
authors.initials: L
authors.lastname: Shi
authors.forename: Donglan
authors.initials: D
authors.lastname: Zhang
authors.forename: Jeroen
authors.initials: J
authors.lastname: van Meijgaard
authors.forename: Kara E
authors.initials: KE
authors.lastname: MacLeod
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Fielding
mesh_terms: D000069:Acculturation; D000293:Adolescent; D000328:Adult; D000368:Aged; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology*; D055815:Young Adult