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Neighbourhood socioeconomic status and cross-sectional associations with obesity and urinary biomarkers of diet among New York City adults: the heart follow-up study
  1. Tali Elfassy1,
  2. Stella S Yi2,
  3. Maria M Llabre3,
  4. Neil Schneiderman3,
  5. Marc Gellman3,
  6. Hermes Florez1,
  7. Guillermo Prado1,
  8. Adina Zeki Al Hazzouri1
  1. 1 Department of Public Health Sciences, University of Miami, Miami, Florida, USA
  2. 2 Department of Population Health, New York University School of Medicine, New York, USA
  3. 3 Department of Psychology, University of Miami, Coral Gables, Florida, USA
  1. Correspondence to Dr Tali Elfassy; t.elfassy{at}


Objective To determine whether neighbourhood socioeconomic status (SES) is associated with body mass index (BMI), waist circumference (WC) and biomarkers of diet (urinary sodium and potassium excretion).

Design A cross-sectional study.

Setting The data reported were from the 2010 Heart Follow-up Study, a population-based representative survey of 1645 adults.

Participants Community-dwelling diverse residents of New York City nested within 128 neighbourhoods (zip codes).

Primary and secondary outcome measures BMI (kg/m2) and WC (inches) were measured during in-home visits, and 24-hour urine sample was collected to measure biomarkers of diet: sodium (mg/day) and potassium (mg/day), with high sodium and low potassium indicative of worse diet quality.

Results After adjusting for individual-level characteristics using multilevel linear regressions, low versus high neighbourhood SES tertile was associated with 1.83 kg/m2 higher BMI (95% CI 0.41 to 3.98) and 251 mg/day lower potassium excretion (95% CI −409 to 93) among women only, with no associations among men (P values for neighbourhood SES by sex interactions <0.05).

Conclusion Our results suggest that women may be particularly vulnerable to the effects of a socioeconomically disadvantaged neighbourhood. Future neighbourhood research should explore sex differences, as these can inform tailored interventions.

Trial registration number NCT01889589; Results.

  • public health
  • epidemiology

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  • Contributors TE conducted the statistical analyses for this study. TE and AZAH interpreted the data and drafted the manuscript. TE, SY, MML, NS, MG, HF, GP and AZAH contributed to the methodological aspects of this study and were all involved with critical review of the manuscript.

  • Funding The HFUS was supported by funding from the Robert Wood Johnson Foundation, the New York State Health Foundation, the National Association of County and City Health Officials and the Centres for Disease Control and Prevention (grant no: 5U38HM000449-02), the W.K. Kellogg Foundation and the US Department of Health and Human Services. This funding is administered by the Fund for Public Health in New York, a private non-profit organisation that supports innovative initiatives of the New York City Department of Health and Mental Hygiene. TE was supported by the American Heart Association postdoctoral fellowship (17POST32490000) and the T32 training grant from the National Institutes of Health, National Heart, Lung and Blood Institute (HL007426). SY was supported by P60MD000538 from the National Institutes of Health (NIH)/National Institute on Minority Health and Health Disparities and U58DP005621 from the Centres for Disease Control and Prevention (CDC). AZAH was supported by a grant from the National Institutes of Health, National Institute on Ageing (K01AG047273).

  • Disclaimer The contents of this article are solely the responsibility of the authors and do not necessarily represent the official view of the funders.

  • Competing interests None declared.

  • Ethics approval Institutional review board approval from both the University of Miami and New York City Department of Health and Mental Hygiene.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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