Adherence
Individual demographic and socioeconomic factors explain the majority of spatial clustering in extreme BMI values among adults with diabetes, whereas neighborhood environmental factors (food access, deprivation) explain a significantly smaller portion.
If you are managing diabetes and weight, your personal socioeconomic situation and personal choices are stronger predictors of your BMI clustering than the specific food stores or walkability of your immediate neighborhood. While improving neighborhood access is good, focusing on individual-level factors (income, education, personal habits) is likely to have a larger impact on your weight status than relying solely on environmental changes.
Individual characteristics explained somewhat more of clustering of the BMI values than did neighborhood characteristics... Individual factors explained roughly 68% of the local BMI clustering... Adjusting for only neighborhood factors reduced the Global Moran’s I by half but it remained significant.
Why this rating
Large sample size (n=15,854) and robust spatial statistical methods, but cross-sectional design limits causal inference.
Source
Spatial pattern of body mass index among adults in the diabetes study of Northern California (DISTANCE)
Barbara Laraia et al. · International Journal of Health Geographics · 2014
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