title: Area-Level Socioeconomic Gradients in Overweight and Obesity in a Community-Derived Cohort of Health Service Users - A Cross-Sectional Study.
abstract: BACKGROUND
  Overweight and obesity lead to higher probability of individuals accessing primary care but adiposity estimates are rarely available at regional levels to inform health service planning. This paper analyses a large, community-derived clinical database of objectively measured body mass index (BMI) to explore relationships with area-level socioeconomic disadvantage for informing regional level planning activities.
  
  
  METHODS
  The study included 91776 adults who had BMI objectively measured between 1 July 2009 and 30 June 2011 by a single pathology provider. Demographic data and BMI were extracted and matched to 2006 national census socioeconomic data using geocoding. Adjusted odds-ratios for overweight and obesity were calculated using sex-stratified logistic regression models with socioeconomic disadvantage of census collection district of residence as the independent variable.
  
  
  RESULTS
  The prevalence of overweight or obesity was 79.2% (males) and 65.8% (females); increased with age to 74 years; and was higher in rural (74%) versus urban areas (71.4%) (p<0.001). Increasing socioeconomic disadvantage was associated with increasing prevalence of overweight (p<0.0001), obesity (p<0.0001) and overweight or obesity (p<0.0001) in women and obesity (p<0.0001) in men. Socioeconomic disadvantage was unrelated to overweight (p = 0.2024) and overweight or obesity (p = 0.4896) in males.
  
  
  CONCLUSIONS
  It is feasible to link routinely-collected clinical data, representative of a discrete population, with geographic distribution of disadvantage, and to obtain meaningful area-level information useful for targeting interventions to improve population health. Our results demonstrate novel area-level socioeconomic gradients in overweight and obesity relevant to regional health service planning.
authors: University of Wollongong, Graduate School of Medicine, Wollongong, New South Wales, 2522, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, New South Wales, 2522, Australia.
authors: Andrew
authors: A
authors: Bonney
authors: Public Health, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, 2500, Australia; Illawarra Health and Medical Research Institute, University of Wollongong, New South Wales, 2522, Australia; Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, 2006, Australia.
authors: Darren J
authors: DJ
authors: Mayne
authors: Sonic Healthcare Ltd, North Ryde, New South Wales, 2113, Australia.
authors: Bryan D
authors: BD
authors: Jones
authors: Southern.IML Pathology, Wollongong, New South Wales, 2500, Australia.
authors: Lawrence
authors: L
authors: Bott
authors: University of Wollongong, Graduate School of Medicine, Wollongong, New South Wales, 2522, Australia; Southern.IML Pathology, Wollongong, New South Wales, 2500, Australia.
authors: Stephen E J
authors: SE
authors: Andersen
authors: University of Wollongong, Centre for Health Initiatives, Wollongong, New South Wales, 2522, Australia.
authors: Peter
authors: P
authors: Caputi
authors: University of Wollongong, Graduate School of Medicine, Wollongong, New South Wales, 2522, Australia.
authors: Kathryn M
authors: KM
authors: Weston
authors: Swinburne University of Technology, Faculty of Health, Arts and Design, Hawthorne, Victoria, 3122, Australia.
authors: Don C
authors: DC
authors: Iverson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D003153:Community Health Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005240:Feasibility Studies; D005260:Female; D005843:Geography; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult