Social vulnerability effect over obesity anthropometric indexes: results from population-based epidemiological study.

OBJECTIVES The study aimed at evaluating the contextual effects of social vulnerability over anthropometric indexes related to global and central obesity in adults living in Ribeirão Preto (SP), Brazil, in 2006. METHODS In a population-based cross-sectional study using multistage sampling, multilevel linear models were applied considering two levels: ecological and individual. The 81 census tracts drafted for sample composition were considered the ecological level and classified according to Paulista Social Vulnerability Index (IPVS). RESULTS Individual correlates to body mass index (BMI) were age, familial and personal antecedents of overweight, and total fat consumption (direct relationship), exception to gender and schooling (inverse relationship). Individual correlates to waist circumference were age, familial antecedents of stroke, personal antecedent of overweight, BMI, number of medicines taken, time of smoking, and diet total energy (direct relationship), exception to gender (inverse relationship). Considering both outcomes (BMI and waist circumference), in the final models, the variance of IPVS showed statistical significance (p < 0.05), depicting the contextual effect (rho ≈ 8%) over global and central obesity, even after the adjustment for individual correlates. CONCLUSION Results showed that interventions to promote healthy behaviors and to prevent obesity might be focused not only on individual factors but also on socioenvironmental context in which people are inserted.