title: Neighbourhood socioeconomic context, individual socioeconomic position, and overweight in young children: a multilevel study in a large German city.
abstract: BACKGROUND
  The context of the close neighbourhood environment in which children live has gained increasing attention in epidemiological research. This study aimed to investigate if contextual neighbourhood socioeconomic position (SEP) was independently associated with overweight in young children aged 5-7 years while simultaneously considering a wide range of individual socioeconomic determinants and known risk factors for overweight.
  
  
  METHODS
  Objectively measured body mass index (BMI) data from 3499 children (53 % boys and 47 % girls) from three surveys between 2004 and 2007 clustered in 18 school enrolment zones in the city of Munich, Germany, were analysed with hierarchical logistic regression models. An index of neighbourhood SEP was calculated with principal component analysis using aggregated data. Individual socioeconomic data, maternal BMI, and birth weight were collected with parental questionnaires. We analysed how much of the between neighbourhood variance of overweight was attributable to individual factors and how much was explained by neighbourhood SEP.
  
  
  RESULTS
  The prevalence of overweight, including obesity, was 14.1 %. In the final adjusted model low neighbourhood SEP was independently associated with overweight (odds ratio (OR) = 1.42, 95 % confidence interval (CI) = 1.00-2.00) compared to high neighbourhood SEP. On the individual level low parental education (OR = 1.99, 95 % CI = 1.49-2.65) or middle parental education (OR = 1.50, 95 % CI = 1.16-1.95) compared to high parental education and nationality of the child other than German (OR = 1.53, 95 % CI = 1.17-1.99) compared to German nationality were independently associated with overweight.
  
  
  CONCLUSIONS
  Whereas individual determinants were the main drivers in explaining between neighbourhood variance, neighbourhood SEP additionally explained differences in overweight between neighbourhoods. Thus, considering neighbourhood context in intervention planning could result in more effective strategies compared to measures only focusing on individual determinants of overweight.
authors.affiliation: Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
authors.forename: Steffen Andreas
authors.initials: SA
authors.lastname: Schüle
authors.affiliation: Institute of Social Paediatrics and Adolescent Medicine, Ludwig Maximilian University, Munich, Germany.
authors.forename: Rüdiger
authors.initials: R
authors.lastname: von Kries
authors.affiliation: Bavarian Health and Food Safety Authority, Munich, Germany.
authors.forename: Hermann
authors.initials: H
authors.lastname: Fromme
authors.affiliation: Department of Social Epidemiology, Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bolte
keywords: Children; Contextual factors; Hierarchical regression; Multilevel study; Neighbourhood; Overweight; Socioeconomic position