Downloadable Content

Download PDF
Last Modified
  • March 21, 2019
  • Miles, Gandarvaka
    • Affiliation: Gillings School of Global Public Health, Department of Epidemiology
  • Obesity has been a major public health problem in the US for more than two decades: it is a risk factor for each of the top ten leading causes of death and over one third of American adults are obese. Living in a socioeconomically deprived neighborhood has been implicated as playing an important role in the development of obesity. However, findings in the literature are mixed, and positive findings have been relatively modest after accounting for individual-level characteristics associated with neighborhood selection. Much of this literature, however, is comprised of cross-sectional studies that neither account for variation in the neighborhood environment over the life course nor investigate potential latent effects of living in a deprived neighborhood in early life. Integration of the life course perspective, which is rooted in sociological theories of the relationship between the social environment and human development, may yield important insights about the influence of neighborhood disadvantage on the risk of obesity in adulthood. Capitalizing on the rich data available from the National Longitudinal Study of Adolescent to Adult Health, this study investigates three life course models of the relationship between the social environment and health: the social trajectories model, the accumulation model, and the critical periods model. The central hypothesis of this research is that the timing, sequence, and accumulation of exposure to neighborhood poverty over the life course influences the risk of obesity in adulthood. We present empirical evidence of a direct effect of adolescent neighborhood poverty on the risk of obesity in adulthood through pathways not mediated by adult neighborhood poverty among males, females, and non-Hispanic whites as well as cumulative effects of adolescent and adult neighborhood poverty on adult obesity among females. Considering the estimated effects of both adolescent and adult neighborhood poverty on adult obesity, findings for males and non-Hispanic whites are consistent with a critical periods model whereby adolescent neighborhood poverty has a direct effect on adult obesity status and adult neighborhood poverty has no effect. In contrast, findings for females are consistent with an accumulation model of the life course: both adolescence and adult exposure to high poverty neighborhoods are independently associated with an increased risk of obesity in adulthood. These findings help lay the foundation for future studies that explore longitudinal mechanisms linking neighborhood environments to weight status. Furthermore, this study provides information that can help guide program and policy interventions aimed at curbing the American obesity epidemic.
Date of publication
Resource type
Rights statement
  • In Copyright
  • Stevens, June Sheppa
  • Harris, Kathleen Mullan
  • Robinson, Whitney
  • Messer, Lynne
  • Siega-Riz, Anna Maria
  • Doctor of Public Health
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2017

This work has no parents.