Reuters Health  [Printer-friendly version]
February 23, 2006


[Rachel's introduction: With a problem like obesity, we are taught to
focus on individual behaviors and "lifestyle choices." But our
personal behavior occurs within a social context and often the social
context is more important than individual choice in determining
health. This is what people mean when they talk about the "social
determinants of health."]

By Charnicia Huggins

NEW YORK (Reuters Health) -- The neighborhood an adolescent lives in
may influence his or her development of obesity, new study findings
suggest. Specifically, investigators found that adolescents from
close-knit neighborhoods were less likely to be obese.

Close-knit neighborhoods exhibited strong collective efficacy --
neighbors get along and are willing to help each other, and many
adults are role models for adolescents.

"There is an obesity epidemic in this country and treatment has
focused on diet and exercise with relatively little success," study
author Dr. Deborah A. Cohen, a senior natural scientist at the Santa
Monica, California-based RAND Corporation, said in a company

The current findings imply that it may be necessary to "look at the
neighborhood environment as potentially very important in controlling
the obesity epidemic," she told Reuters Health.

"The social environment that a child lives in is very strongly
associated with how active they are, what they eat and how much they
eat," she said.]

Previous studies show that a neighborhood's level of collective
efficacy is predictive of crime, premature death, death from
cardiovascular disease and other health outcomes. In a survey of 684
households in 65 Los Angeles County neighborhoods, Cohen and her team
investigated whether collective efficacy may also indirectly affect
factors related to obesity. The study included 807 adolescences and
3000 adults.

Cohen's group found that adolescents who lived in neighborhoods with
high levels of collective efficacy were also less likely to be
overweight or at risk for overweight and had a lower body mass index
-- a ratio of weight to height -- than did their peers in other

Adolescents in low-collective efficacy neighborhoods, on the other
hand, were 64 percent more likely to be at-risk-for-overweight and 52
percent more likely to be overweight than those living in
neighborhoods with an average level of collective efficacy, the
researchers report in the journal Social Science & Medicine.

In fact, collective efficacy was more important in predicting obesity
than the ethnic or racial make-up of the neighborhood, or the income
of its residents, Cohen noted.

The reason for the association is unknown, but Cohen speculated that
children in neighborhoods with high collective efficacy may be more
likely to play outside rather than sit inside and watch television.
Or, she said, "maybe (their) neighborhoods look different," with more
parks and fewer fast food restaurants.

Based on the findings, "we need to start looking at our environments,"
she said, and ask: "Are there places for kids to play? Billboard
advertisements for fast foods?"

Citing the potential for neighborhood groups to create a sports league
or get a park for children to play in, she said, "together people can
change their environment and make it healthy."

SOURCE: Social Science & Medicine, February 2006.

Copyright 2006 Reuters