Patterson, KAE and Gall, SL and Venn, AJ and Otahal, P and Blizzard, CL and Dwyer, T and Cleland, V, Accumulated exposure to rural areas of residence over the life course is associated with overweight and obesity in adulthood: a 25-year prospective cohort study, Annals of Epidemiology, 27, (3) pp. 169-175. ISSN 1047-2797 (2017) [Refereed Article]
Copyright 2017 Elsevier Inc.
Purpose : This prospective cohort study investigated whether body mass index (BMI) and weight status in mid-adulthood were predicted by trajectories of urban-rural residence from childhood to adulthood.
Methods : Participants aged 7–15 years in 1985 (n = 8498) were followed up in 2004–2006 (n = 3999, aged 26–36 years) and 2009–2011 (n = 3049, aged 31–41 years). Area of residence (AOR) was classified as urban or rural at each time point. BMI and/or weight status was calculated from self-reported weight and height (2009–2011). We tested which of three life-course models ("accumulation," "sensitive period," "mobility") best explained the AOR-BMI and/or weight status association using a novel life-course modeling framework.
Results : Accumulation and sensitive period models best described the effect of AOR on mid-adulthood BMI and weight status. Those with greater accumulated exposure to rural areas had a higher BMI (β = 0.29 kg/m2 per time in a rural area, P = .005) and were more likely obese (relative risk = 1.13 per time in a rural area, P = .002). Living in rural areas at ages 26–30 years was also associated with a higher BMI and obesity in mid-adulthood.
Conclusions : Greater cumulative exposure to rurality and exposure during the "sensitive period" of young adulthood is associated with obesity in middle-aged adults. This study highlights the important contribution of context to the development of obesity over the life course.
|Item Type:||Refereed Article|
|Keywords:||obesity, rural health, longitudinal studies, life course, body mass index, body weight|
|Research Division:||Medical and Health Sciences|
|Research Group:||Public Health and Health Services|
|Objective Group:||Specific Population Health (excl. Indigenous Health)|
|Objective Field:||Rural Health|
|Author:||Patterson, KAE (Miss Kira Patterson)|
|Author:||Gall, SL (Dr Seana Gall)|
|Author:||Venn, AJ (Professor Alison Venn)|
|Author:||Otahal, P (Mr Petr Otahal)|
|Author:||Blizzard, CL (Associate Professor Leigh Blizzard)|
|Author:||Dwyer, T (Professor Terry Dwyer)|
|Author:||Cleland, V (Dr Verity Cleland)|
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