Community Built Environment and Multilevel Social Determinants of Obesity in China

Libin Zhang, University of Massachusetts at Boston
Tim Futing Liao, University of Illinois at Urbana-Champaign
Laura Hayman, University of Massachusetts at Boston

Social determinants of obesity and effects of the community built environment remain poorly understood in developing nations. We synthesized literature on socio-economic (SES) gradients and income inequality effects on health and analyzed data from China Health and Nutrition Survey (N=9,586) to understand how multilevel social determinants of obesity varied by built environments assessed by fast food restaurants and sports facilities. We found that at the individual-level, obesity was positively associated with income and wealth but negatively associated with education and manual occupation. At the community-level, obesity was negatively associated with income inequality in north regions. SES effects on obesity varied across built environmental contexts; inequality effects on obesity remained significant and consistently negative across contexts. All these social determinants effects were pronounced in communities with the presence of fast food but absence of sports facilities. SES and inequality effects on obesity in China are different from those in developed countries.

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Presented in Session 31: Determinants and Consequences of Obesity and Weight Gain in International Contexts