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Neighbourhood socioeconomic status and overweight/obesity: a systematic review and meta-analysis of epidemiological studies
  1. Shimels Hussien Mohammed1,
  2. Tesfa Dejenie Habtewold2,3,
  3. Mulugeta Molla Birhanu4,
  4. Tesfamichael Awoke Sissay5,
  5. Balewgizie Sileshi Tegegne2,
  6. Samer Abuzerr6,
  7. Ahmad Esmaillzadeh1,7,8
  1. 1 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  2. 2 Department of Epidemiology, University of Groningen, Groningen, The Netherlands
  3. 3 Department of Nursing, Debre Berhan University, Debre Berhan, Ethiopia
  4. 4 Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  5. 5 Department of Public Health, School of Public Health, Addis Ababa University, Addis Ababa, Ethiopia
  6. 6 Department of Environmental Health Engineering, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  7. 7 Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran (the Islamic Republic of)
  8. 8 Department of Community Nutrition, Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran (the Islamic Republic of)
  1. Correspondence to Dr Shimels Hussien Mohammed; shimelsh{at}


Objective Low neighbourhood socioeconomic status (NSES) has been linked to a higher risk of overweight/obesity, irrespective of the individual’s own socioeconomic status. No meta-analysis study has been done on the association. Thus, this study was done to synthesise the existing evidence on the association of NSES with overweight, obesity and body mass index (BMI).

Design Systematic review and meta-analysis.

Data sources PubMed, Embase, Scopus, Cochrane Library, Web of Sciences and Google Scholar databases were searched for articles published until 25 September 2019.

Eligibility criteria Epidemiological studies, both longitudinal and cross-sectional ones, which examined the link of NSES to overweight, obesity or BMI, were included.

Data extraction and synthesis Data extraction was done by two reviewers, working independently. The methodological quality of included studies was assessed using the Newcastle-Ottawa Scale for the observational studies. The summary estimates of the relationships of NSES with overweight, obesity and BMI statuses were calculated with random-effects meta-analysis models. Heterogeneity was assessed by Cochran’s Q and I2 statistics. Subgroup analyses were done by age categories, continents, study designs and NSES measures. Publication bias was assessed by visual inspection of funnel plots and Egger’s regression test.

Result A total of 21 observational studies, covering 1 244 438 individuals, were included in this meta-analysis. Low NSES, compared with high NSES, was found to be associated with a 31% higher odds of overweight (pooled OR 1.31, 95% CI 1.16 to 1.47, p<0.001), a 45% higher odds of obesity (pooled OR 1.45, 95% CI 1.21 to 1.74, p<0.001) and a 1.09 kg/m2 increase in mean BMI (pooled beta=1.09, 95% CI 0.67 to 1.50, p<0.001).

Conclusion NSES disparity might be contributing to the burden of overweight/obesity. Further studies are warranted, including whether addressing NSES disparity could reduce the risk of overweight/obesity.

PROSPERO registration number CRD42017063889

  • neighbourhood socioeconomic status
  • obesogenic environment
  • overweight
  • obesity
  • meta-analysis

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  • Twitter @Tesfa Dejenie.

  • Contributors SHM conceived and lead the study, carried out literature search, performed quality assessment, analysed the data and wrote the manuscript. TDH, TAS, MMB, BST and SA performed literature search, screening, data extraction and quality assessment as second reviewers. AE supervised the work. All authors read, commented and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.

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