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Epidemiology
Research
Does the ethnic density effect extend to obesity? A cross-sectional study of 415 166 adults in east London
  1. Shailen Sutaria,
  2. Rohini Mathur,
  3. Sally A Hull
  1. Clinical Effectiveness Group, Queen Mary University of London, London, UK
  1. Correspondence to Dr Sally A Hull; s.a.hull{at}qmul.ac.uk

Abstract

Objectives To examine the prevalence of obesity by ethnic group and to examine the association between ethnic density and obesity prevalence.

Design and setting Cross-sectional study utilising electronic primary care records of 128 practices in a multiethnic population of east London.

Participants Electronic primary care records of 415 166 adults with a body mass index recorded in the previous 3 years.

Outcome measures (1) Odds of obesity for different ethnic groups compared with white British. (2) Prevalence of obesity associated with each 10% increase in own-group ethnic density, by ethnic group.

Results Using multilevel logistic regression models, we find that compared with white British/Irish males, the odds of obesity were significantly higher among black ethnic groups and significantly lower among Asian and white other groups. Among females, all ethnic groups except Chinese and white other were at increased odds of obesity compared with white British/Irish. There was no association between increasing ethnic density and obesity prevalence, except among black Africans and Indian females. A 10% increase in black ethnic density was associated with a 15% increase in odds of obesity among black African males (95% CI 1.07 to 1.24) and 18% among black African females (95% CI 1.08 to 1.30). Among Indian females, a 10% increase in Indian ethnic density was associated with a 7% decrease in odds of obesity (95% CI 0.88 to 0.99).

Conclusion Wider environmental factors play a greater role in determining obesity than the ethnic composition of the area for most ethnic groups. Further research is needed to understand the mechanism through which increasing ethnic density is associated with increased odds of obesity among black Africans and decreased odds of obesity among Indian females.

  • ethnic density
  • obesity
  • body mass index

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-024779

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    Footnotes

    • Contributors SH designed the study. SS extracted relevant data from electronic health records. SS and RM conducted statistical analysis, and all authors contributed to data interpretation and revising drafts produced by SS. All authors had full access to all the data collected, have checked for accuracy and have approved the final version of this 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.

    • Disclaimer This article presents independent research. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the Health Foundation or the University. The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

    • Competing interests None declared.

    • Ethics approval Ethical approval was not required as patient-level data are anonymised and aggregated patient data are reported in this study. All GPs in the participating east London practices consented to the use of their anonymised patient data for research and development for patient benefit.

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

    • Data sharing statement No additional data are available.

    • Author note SS is the guarantor of the report. SS affirms that the manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted and that any discrepancies from the study as planned have been explained.

    • Patient consent for publication Not required.

    • Map disclaimer Article contains map figures. Please include below disclaimer in the endnotes. The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.