Do neighbourhood environments contribute to ethnic differences in obesity, physical activity and diets?
Lead Research Organisation:
MRC/CSO Social and Public Health Sciences Unit
Department Name: UNLISTED
Abstract
Halting the rise in obesity is a policy priority as reflected in a range of government initiatives on diet and physical activity in schools and the community, and on legislation to promote a food classification system to make choosing healthy food easy. Ethnic differences in obesity are well known but the cause is poorly understood. This study seeks to understand if the context of where people live plays a role, whether it affects physical exercise and dietary patterns and their body size.
Ethnic minorities tend to live in poor urban areas and these areas might be less well served with facilities for physical activity or might be felt to too unsafe to take up physical exercise. Fast food outlets are known to be more common in deprived areas. Ethnic minorities living in (predominantly White) affluent areas may have better access healthy foods and take more exercise than those living in poor areas. These issues have relevance to policies that aim to help people from different backgrounds to engage in healthy lifestyles and to prevent obesity. For example, if both poor access to recreational facilities and high concentration of South Asians in areas were associated with low physical activity in South Asian women, it would be important to consider culturally appropriate ways of providing these facilities.
We will use national surveys that hold data about physical activity, diet, body size on individuals from ethnic minority groups. We will also use a range of data that describe the context of the areas people live in such as the size of ethnic minority populations living in an area, the poverty level of areas, the crime rates in areas, and the number of fast food outlets and gyms and how far these are from where people live. These data will allow us to examine the extent to which the obesity, physical activity and dietary patterns in ethnic minority groups are shaped by the places they live.
Ethnic minorities tend to live in poor urban areas and these areas might be less well served with facilities for physical activity or might be felt to too unsafe to take up physical exercise. Fast food outlets are known to be more common in deprived areas. Ethnic minorities living in (predominantly White) affluent areas may have better access healthy foods and take more exercise than those living in poor areas. These issues have relevance to policies that aim to help people from different backgrounds to engage in healthy lifestyles and to prevent obesity. For example, if both poor access to recreational facilities and high concentration of South Asians in areas were associated with low physical activity in South Asian women, it would be important to consider culturally appropriate ways of providing these facilities.
We will use national surveys that hold data about physical activity, diet, body size on individuals from ethnic minority groups. We will also use a range of data that describe the context of the areas people live in such as the size of ethnic minority populations living in an area, the poverty level of areas, the crime rates in areas, and the number of fast food outlets and gyms and how far these are from where people live. These data will allow us to examine the extent to which the obesity, physical activity and dietary patterns in ethnic minority groups are shaped by the places they live.
Technical Summary
Background: Halting the rise in obesity is a policy priority as reflected in a range of government initiatives on diet and physical activity in schools and the community, and on legislation to promote a food classification system to make choosing healthy food easy. This study will enhance these initiatives by developing the evidence base about the extent to which ethnic minorities are exposed to obesogenic (obesity promoting) environments. In adulthood, Black Caribbean, Black African and Pakistani women are more likely to be obese than women in the general population. South Asians are more prone to abdominal adiposity. In adolescence, Black African origin girls are already more likely to be obese. In contrast to the US, there is very little research on the effect of neighbourhood environments on ethnic differences in health in the UK. Ethnic minority groups are spatially concentrated in relatively deprived urbanised areas and worry more about crime than their White peers. Physical characteristics of the neighbourhood such as the presence of grocery stores that sell healthy foods, safe parks, and recreational facilities, may promote healthy eating and exercise through increased availability and accessibility. Deprived areas may be less well served with these facilities. Perceptions of safety in neighbourhoods also influence the likelihood of taking physical activity.
Aim: The overall aim of this study is to examine whether ethnic differences in physical activity and dietary patterns, BMI and obesity status are related to exposures in the neighbourhoods they live in.
Method: The Health Surveys for England (HSE) (1999 and 2004) holds a range of data on individuals (e.g. including physical activity, diet, body size) from the major ethnic minority groups. Area measures of ethnic density, deprivation, food retail environment and physical activity opportunities will be obtained from a range of data sources (e.g. Neighbourhood Statistics, SportEngland). These ecologic data will be merged to the individual records on the HSE. The distribution of resources and the mean distance from to the nearest resource will be explored in relation to deprivation and ethnic density. Different measures of ethnic density will be used to reflect concentration and clustering in particular areas. Multilevel models will be used to examine how individual characteristics (compositional factors) and area-level variables (contextual factors) relate to ethnic differences in outcomes.
Aim: The overall aim of this study is to examine whether ethnic differences in physical activity and dietary patterns, BMI and obesity status are related to exposures in the neighbourhoods they live in.
Method: The Health Surveys for England (HSE) (1999 and 2004) holds a range of data on individuals (e.g. including physical activity, diet, body size) from the major ethnic minority groups. Area measures of ethnic density, deprivation, food retail environment and physical activity opportunities will be obtained from a range of data sources (e.g. Neighbourhood Statistics, SportEngland). These ecologic data will be merged to the individual records on the HSE. The distribution of resources and the mean distance from to the nearest resource will be explored in relation to deprivation and ethnic density. Different measures of ethnic density will be used to reflect concentration and clustering in particular areas. Multilevel models will be used to examine how individual characteristics (compositional factors) and area-level variables (contextual factors) relate to ethnic differences in outcomes.
Organisations
- MRC/CSO Social and Public Health Sciences Unit (Lead Research Organisation)
- Ministry of Health (Collaboration)
- Ministry of Public Health (Collaboration)
- Pan American Health Organization (Collaboration)
- UNIVERSITY OF GHANA (Collaboration)
- Ross University (Collaboration)
- New York University (Collaboration)
- University of West Indies (Collaboration)
- Jamaica Ministry of Health (Collaboration)
People |
ORCID iD |
Seeromanie Harding (Principal Investigator) |
Publications
Maynard M
(2009)
Ethnic differences in psychological well-being in adolescence in the context of time spent in family activities
in Social Psychiatry and Psychiatric Epidemiology
Twamley K
(2010)
UK-born ethnic minority women and their experiences of feeding their newborn infant
in Midwifery
Harding S
(2010)
Emergence of ethnic differences in blood pressure in adolescence: the determinants of adolescent social well-being and health study.
in Hypertension (Dallas, Tex. : 1979)
Puthussery S
(2010)
'You need that loving tender care': maternity care experiences and expectations of ethnic minority women born in the United Kingdom
in Journal of Health Services Research & Policy
Bhala N
(2010)
Peptic ulcer disease: further work is required to reduce inequalities.
in Lancet (London, England)
Whitrow MJ
(2010)
The influence of parental smoking and family type on saliva cotinine in UK ethnic minority children: a cross sectional study.
in BMC public health
Mutrie Nanette
(2010)
Recruiting Hard-to-Reach Populations to Physical Activity Studies: Evidence and Experiences
in JOURNAL OF PHYSICAL ACTIVITY & HEALTH
Maynard MJ
(2010)
Perceived parenting and psychological well-being in UK ethnic minority adolescents.
in Child: care, health and development
Whitrow MJ
(2010)
Asthma in Black African, Black Caribbean and South Asian adolescents in the MRC DASH study: a cross sectional analysis.
in BMC pediatrics
Mitchell R
(2011)
A comparison of green space indicators for epidemiological research.
in Journal of epidemiology and community health
Akinwale B
(2011)
Work, permanent sickness and mortality risk: a prospective cohort study of England and Wales, 1971-2006.
in Journal of epidemiology and community health
Booker CL
(2011)
A systematic review of the effect of retention methods in population-based cohort studies.
in BMC public health
Astell-Burt T
(2011)
Does geographic access to primary healthcare influence the detection of hepatitis C?
in Social science & medicine (1982)
Read U
(2012)
"I want the one that will heal me completely so it won't come back again": The limits of antipsychotic medication in rural Ghana
in Transcultural Psychiatry
Molaodi O
(2012)
Neighbourhood food and physical activity environments in England, UK: does ethnic density matter?
in International Journal of Behavioral Nutrition and Physical Activity
Bhui K
(2012)
Ethnic inequalities in mental health status and care: unravelling the determinants and consequences. Editors' foreword.
in Ethnicity & health
Bhopal RS
(2012)
Mortality from circulatory diseases by specific country of birth across six European countries: test of concept.
in European journal of public health
Read UM
(2012)
Mental health research in Ghana: a literature review.
in Ghana medical journal
Richardson EA
(2012)
Green cities and health: a question of scale?
in Journal of epidemiology and community health
Astell-Burt T
(2012)
Is travel-time to a specialist centre a risk factor for non-referral, non-attendance and loss to follow-up among patients with hepatitis C (HCV) infection?
in Social science & medicine (1982)
Vandenheede H
(2012)
Migrant mortality from diabetes mellitus across Europe: the importance of socio-economic change.
in European journal of epidemiology
Maynard MJ
(2012)
Trends in suicide among migrants in England and Wales 1979-2003.
in Ethnicity & health
Astell-Burt T
(2012)
Racism, ethnic density and psychological well-being through adolescence: evidence from the Determinants of Adolescent Social Well-Being and Health longitudinal study.
in Ethnicity & health
Bhui KS
(2012)
Does cultural integration explain a mental health advantage for adolescents?
in International journal of epidemiology
Harding S
(2013)
Trends in mortality by labour market position around retirement ages in three European countries with different welfare regimes.
in International journal of public health
Rawlins E
(2013)
Perceptions of healthy eating and physical activity in an ethnically diverse sample of young children and their parents: the DEAL prevention of obesity study.
in Journal of human nutrition and dietetics : the official journal of the British Dietetic Association
Etyang A
(2013)
Slum living and hypertension in tropical settings: neglected issue, statistical artifact or surprisingly slight? Insights amidst adversity.
in Journal of hypertension
Brueton, V
(2013)
Systematic review of strategies to reduce attrition in randomised trials
in British Medical Journal
Read, U
(2013)
"No matter how the child is she is hers": Practical kinship in the care of mental illness in Kintampo, Ghana
in Ghana Studies
Brueton VC
(2013)
Strategies to improve retention in randomised trials.
in The Cochrane database of systematic reviews
Astell-Burt T
(2013)
Effect of air pollution and racism on ethnic differences in respiratory health among adolescents living in an urban environment.
in Health & place
Sieger T
(2013)
Basal ganglia neuronal activity during scanning eye movements in Parkinson's disease.
in PloS one
Rafnsson SB
(2013)
Sizable variations in circulatory disease mortality by region and country of birth in six European countries.
in European journal of public health
Harding S
(2014)
Determinants of Adolescent Social well-being and Health (DASH) cohort- now in their 20s
in Open Health Data
Seaman S R
(2014)
Handling missing data in observational cohort studies
in Journal of Longitudinal and Life Course Studies
Read UM
(2014)
Health inequalities: from ethnicity to diversity.
in Ethnicity & health
Brueton VC
(2014)
Strategies to improve retention in randomised trials: a Cochrane systematic review and meta-analysis.
in BMJ open
Reid A
(2014)
The changing pattern of migration to Australia and its impact on deaths and hospital admissions from work-related injuries
in World Health Bulletin
Tompkins C
(2014)
Experiences of traditional hospital follow-up for breast cancer: Implications for new survivorship models from a multi-ethnic sample in England
in BMC Public Health
Wilks R
(2014)
P10.4 EARLY LIFE PREDICTORS OF BLOOD PRESSURE IN AFRO-CARIBBEAN YOUNG ADULTS: THE JAMAICA 1986 BIRTH COHORT STUDY
in Artery Research
Brueton VC
(2014)
Use of strategies to improve retention in primary care randomised trials: a qualitative study with in-depth interviews.
in BMJ open
Read, UM
(2014)
Cosmos, Gods and Madmen in the Anthropology of Medicine
Akinwale, B
(2014)
Combining caring and paid employment in late middle age: health penalties and paradoxes
in Social Science and Medicine
Reid A
(2014)
Taking risks and survival jobs: Foreign-born workers and work-related injuries in Australia
in Safety Science
Description | Big lottery Fund |
Amount | £395,973 (GBP) |
Organisation | Big Lottery Fund |
Sector | Public |
Country | United Kingdom |
Start | 03/2011 |
End | 03/2015 |
Description | CLRN |
Amount | £105,000 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 09/2012 |
End | 03/2014 |
Description | Department of Health -Public Health Consortium |
Amount | £4,200,000 (GBP) |
Organisation | National Institute for Health Research |
Sector | Public |
Country | United Kingdom |
Start | 02/2011 |
End | 05/2016 |
Description | KCL Together |
Amount | £50,000 (GBP) |
Organisation | King's College London |
Sector | Academic/University |
Country | United Kingdom |
Start | 04/2017 |
End | 03/2018 |
Description | Overcoming ethnic differences: A 3-D approach to somatic growth when predicting lung function in children |
Amount | £1,160,000 (GBP) |
Funding ID | 094129/B/10/Z |
Organisation | Wellcome Trust |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 01/2010 |
End | 12/2015 |
Description | Overcoming ethnic differences: A 3-D approach to somatic growth when predicting lung function in children |
Amount | £50,000 (GBP) |
Organisation | Asthma + Lung UK |
Sector | Charity/Non Profit |
Country | United Kingdom |
Start | 04/2010 |
End | 12/2011 |
Title | Ground Truthing |
Description | Ground truthing of national data on structures that influence dietary behaviour (e.g. fast food outlets, supermarkets) and physical activity (e.g. green space, gyms), via collection of data in 4 cities in the UK. |
Type Of Material | Biological samples |
Provided To Others? | No |
Impact | Caution in the use of nationally available data on these opportunity structures as epidemelogical exposures as ground truthing revealed least accurate in ethnically dense areas. |
Title | Merged HSE and ecological data |
Description | Merged data set from various national sources |
Type Of Material | Biological samples |
Provided To Others? | No |
Impact | Enhancing routinely collected survey data; Knowledge of the process of merging national data sets in compliance with protecting disclosure procedures |
Title | Neighbourhood data and GIS data maps |
Description | 1. For all LSOAs in England: -Number of facilities (fast food outlets, supermarkets, indoor and outdoor physical activity facilities) per 1000 population linked to area deprivation (income domain of Index of Multiple deprivation, 2004), ethnic concentration, ethnic density and urbanicity measures. -Distances (in metres): from the LSOA population centroid to the nearest facility for each of fast food outlets, supermarkets, indoor and outdoor physical activity facilities. -Time (in minutes): from the LSOA population centroid to the nearest facility fast food outlets, supermarkets, indoor and outdoor physical activity facilities; -Counts of facilities (fast food outlets, supermarkets, indoor and outdoor physical activity facilities) within buffer zones of 500m and 1km. 2. Maps of facilities by deprivation and ethnic density for cities with large ethnic minorities. |
Type Of Material | Biological samples |
Provided To Others? | No |
Impact | The effect of using different accessibility measures to measure neighbourhood environments. |
Description | Transdisciplinary collaboration |
Organisation | Jamaica Ministry of Health |
Country | Jamaica |
Sector | Public |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | Ministry of Health |
Country | Rwanda |
Sector | Public |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | Ministry of Public Health |
Country | Lebanon |
Sector | Public |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | New York University |
Department | School of Medicine |
Country | United States |
Sector | Academic/University |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | Pan American Health Organization |
Country | United States |
Sector | Charity/Non Profit |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | Ross University |
Country | United States |
Sector | Academic/University |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | University of Ghana |
Country | Ghana |
Sector | Academic/University |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Transdisciplinary collaboration |
Organisation | University of West Indies |
Country | Jamaica |
Sector | Academic/University |
PI Contribution | - Supported capacity building of young scientists via training in theory and methods, grant administration, general research governance - Supported widening of collaborative networks (UWI, UG, Ross University, NYU, KCL, University of Illinois) |
Collaborator Contribution | Ministries of Health/Public Health -access to primary care clinics and permission for staff to take part in the research; press coverage; cabinet support for project PAHO - training of Health Advocates Universities - support for medical/MPH/social science students to take part in the project |
Impact | Protocol Paper presented at Caribbean Public Health Conference 2016 Media releases - region wide |
Start Year | 2016 |
Description | Advisory Group 2009-2011 SH |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Geographic Reach | National |
Primary Audience | Public/other audiences |
Results and Impact | Event: Advisory groups 2009-11 SH Event type: Collaborators and non-academic committee members Summary: 6 people attended, much discussion around potential relevance of study to the public, town planning, families, local authorities. Possibility of collaboration work with National Obesity Observatory looking at influence of neighbourhoods on child growth/obesity. Policy flyers and data sets with local information requested and will be given after results published |
Year(s) Of Engagement Activity | 2009,2010,2011 |
Description | King's College London 2012 SH |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Type Of Presentation | Paper Presentation |
Geographic Reach | International |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | Location: Diabetes & Nutritional Sciences Division, King's College London Date: 2012 Title: A life course approach to understanding ethnic inequalities in health Authors: Harding S Not known |
Year(s) Of Engagement Activity | 2012 |
Description | King's College London with King's College Hospital 2012 SH |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Type Of Presentation | Paper Presentation |
Geographic Reach | International |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | Date: 2012 Location: Kings College London Title: The ethnic patterning of cardiovascular risk Authors: Harding S Not known |
Year(s) Of Engagement Activity | 2012 |
Description | University of Western Australia 2012 SH |
Form Of Engagement Activity | A talk or presentation |
Part Of Official Scheme? | No |
Type Of Presentation | Paper Presentation |
Geographic Reach | International |
Primary Audience | Other academic audiences (collaborators, peers etc.) |
Results and Impact | Location: Western Australian Institute for Medical Research, University of Western Australia Date: 2012 Location: Perth, Australia Title: Ethnic inequalities in health: a life course approach Authors: Harding S Not known |
Year(s) Of Engagement Activity | 2012 |