Neighborhood Social Environment and Body Mass Index: The Mediating Role of Mental Wellbeing

Author:

Cunningham Shayna D.1ORCID,Mandelbaum Jennifer2ORCID,Shebl Fatma M.34,Abraham Mark5,O’Connor Duffany Kathleen6

Affiliation:

1. Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT 06032, USA

2. Department of Community Health, Tufts University, Medford, MA 02155, USA

3. Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA 02114, USA

4. Harvard Medical School, Boston, MA 02115, USA

5. DataHaven, New Haven, CT 06511, USA

6. Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 06510, USA

Abstract

The association between neighborhood-built environment and body mass index (BMI) is well-characterized, whereas fewer studies have explored the mechanisms underlying the relationship between neighborhood social environment and obesogenic behaviors. Using data from a random sample of 16,820 residents ≥18 years from all 169 Connecticut towns and seven ZIP Codes in New York, this study examines the influence of neighborhood social environment on residents’ mental wellbeing, physical activity, and BMI. Structural equation modeling was conducted to estimate direct and indirect effects of neighborhood social environment on BMI, using mental wellbeing and physical activity as intermediate variables. There were significant total [β(SE) = 0.741 (0.170), p < 0.0001], direct [β(SE) = 0.456 (0.1890), p = 0.016], and indirect [β(SE) = 0.285 (0.061), p < 0.0001] effects of neighborhood social environment on BMI. Low physical activity was a partial mediator of the effect of non-favorable neighborhood social environment on BMI [β(SE) = −0.071 (0.011), p < 0.0001]. The association between neighborhood social environment and BMI was also mediated by mental wellbeing [β(SE) = 0.214 (0.060), p < 0.0001], and by mental wellbeing through physical activity [β(SE) = 0.071 (0.011), p < 0.0001]. Study findings provide further support for building strong social environments to improve population health and suggest that strategies prioritizing mental wellbeing may benefit behavioral interventions aimed at reducing obesity risk and should be a focus of prevention efforts in and of itself.

Funder

Centers for Disease Control and Prevention

Publisher

MDPI AG

Subject

Health, Toxicology and Mutagenesis,Public Health, Environmental and Occupational Health

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