Uncorrected Proof
Jundishapur J Health Sci. In Press(In Press):e122503.
Published online 2022 April 19.
doi: 10.5812/jjhs-122503.
Letter
Does Neighborhood Deprivation Cause Obesity?
Ameneh Marzban
1, *
, Mostafa Madareszadeh
1
and Payam Emami
2
1
Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
2
Department of Emergency Medical Sciences, School of Paramedical Sciences, Kurdistan University of Medical Sciences, Sanandaj, Iran
*
Corresponding author: Department of Health in Disasters and Emergencies, School of Health Management and Information Sciences, Iran University of Medical Sciences,
Tehran, Iran. Email: amenemarzban@yahoo.com
Received 2022 January 18; Revised 2022 February 28; Accepted 2022 March 07.
Keywords: BMI, Neighborhood Deprivation, Obesity, Physical Activity, Weight Gain
Dear Editor,
Neighborhood characteristics can affect people’s activ-
ity. For example, some neighborhood characteristics may
cause people to spend more time at home and not perform
outdoor activities. Therefore, this may lead to obesity by re-
ducing physical activity and increasing sedentary life and
food intake. Research shows that neighborhood charac-
teristics are at least as important as individual characteris-
tics in determining the likelihood of obesity. When the de-
sign of a neighborhood hinders physical activity, it causes
obesity. In other words, environment structure influences
behavior and health outcomes (1). Local parks and walk-
able neighborhoods are often considered elements of the
urban environment that augment physical activity and di-
minish the risk of obesity. In the study by Stark et al. in
New York, extending park space effectively reduced BMI,
and neighborhoods with multiple clean parks could affect
body mass index (BMI) (2).
Therefore, neighborhood deprivation can be consid-
ered a deterrent. Pearson et al. found in a study that higher
neighborhood deprivation and lower access to green space
were associated with a significant rise in the likelihood of
overweight or obesity. Increased access to green space is
accompanied by more walking, while the lack of access to
green space may decrease the level of walking. Moreover,
in this study, neighborhood deprivation was coupled with
reduced walking (3). In France, a study found that living
in a lower socioeconomic status (SES) was correlated with
higher BMI and waist circumference. Conversely, people
living in areas with high SES are more satisfied with the
safety, public transportation, and access to sports facilities
in their community, resulting in a lower risk of obesity.
However, physical space alone is not enough, and the im-
pact of environmental factors at the community level, es-
pecially the perception of the environment, is more impor-
tant in obesity than the physical environment. A national
study on women and children in the United States found
that obesity was more prevalent among those who consid-
ered their neighborhood insecure (4).
In other words, people’s perceptions of social dysfunc-
tion and the collective efficacy in the neighborhood may
affect the amount of time spent outside the home. Social
disturbance is a measure of neighborhood safety that ex-
plains threats to neighborhood conditions and abnormal
behaviors, such as drug trafficking, criminal offense, and
inebriation in public. These activities in a neighborhood
may cause people to restrict outdoor activities, and they
have to stay in their homes. Therefore, daily energy con-
sumption will decline (5). The social conditions in which
people live have a profound effect on their health. Fac-
tors such as poverty, poor nutrition, poor housing, un-
employment, insecure income, low education, social dis-
crimination, and living in deprived environments are the
main determinants of health and health inequality. Medi-
cal care can indeed prolong the life or cure a severe illness,
while what is essential for population health is the socioe-
conomic conditions that make people sick or in need of
medical care (6).
Collective efficacy is a scale for people to understand
connection and closeness with their neighbors (social con-
tinuity and confidence) and the neighbors’ capacity to
participate in activities to benefit the neighborhood to
achieve common goals (informal social control). Conse-
quently, low levels of perceived collective efficacy, such as
the lack of safety in the neighborhood, may cause people
to stay at home. If the neighborhoods are not safe or peo-
ple do not have a connection with their neighbors, this can
lead to increased psychological stress. For some people, if
stress is persistent, it may result in functional disturbance
through anxiety or depression. These feelings can exacer-
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