Journal of Urban Health

, Volume 94, Issue 6, pp 791–802 | Cite as

Independent Effects of Neighborhood Poverty and Psychosocial Stress on Obesity Over Time

  • Jamila L. Kwarteng
  • Amy J. Schulz
  • Graciela B. Mentz
  • Barbara A. Israel
  • Denise White Perkins


The objective of the study was to examine the independent effects of neighborhood poverty and psychosocial stress on increases in central adiposity over time. Data are from a community sample of 157 Non-Hispanic Black, Non-Hispanic White, and Hispanic adults collected in 2002–2003 and 2007–2008, and from the 2000 Decennial Census. The dependent variable was waist circumference. Independent variables included neighborhood poverty, perceived neighborhood physical environment, family stress, safety stress, everyday unfair treatment, and a cumulative stress index. Weighted 3-level hierarchical linear regression models for a continuous outcome were used to assess the effects of neighborhood poverty and psychosocial stress on central adiposity over time. We also assessed whether psychosocial stress mediated the association between neighborhood poverty and central adiposity. Neighborhood poverty and everyday unfair treatment at baseline were independently associated with increases in central adiposity over time, accounting for the other indicators of stress. Perceptions of the neighborhood physical environment and cumulative stress mediated associations between neighborhood poverty and central adiposity. Results suggest that residing in neighborhoods with higher concentrations of poverty and exposure to everyday unfair treatment independently heighten risk of increased central adiposity over time. Associations between neighborhood poverty and central adiposity were mediated by perceptions of the neighborhood physical environment and by the cumulative stress index. Public health strategies to reduce obesity should consider neighborhood poverty and exposure to multiple sources of psychosocial stress, including everyday unfair treatment.


Central adiposity Psychosocial stress Everyday unfair treatment Perceived discrimination Neighborhood poverty 



The Healthy Environments Partnership (HEP) ( is a communitybased participatory research partnership affiliated with the Detroit Community-Academic Urban Research Center ( The authors thank the members of the HEP Steering Committee for their contributions to the work presented here, including representatives from Detroit Department of Health and Wellness Promotion, Detroit Hispanic Development Corporation, Friends of Parkside, Henry Ford Health System, Warren Conner Development Coalition, University of Michigan School of Public Health and community members. The study and analysis were supported by the National Institute of Environmental Health Sciences (NIEHS) (R01ES10936, R01ES014234), the Promoting Ethnic Diversity in Public Health Research Education Project (5-R25-GM058641-11), the Rackham Merit Fellowship, Rackham Graduate School, University of Michigan, and a Summer Mentored Writing Award through the Rackham Faculty Allies program at the University of Michigan. The results presented here are solely the responsibility of the authors and do not necessarily represent the views of NIEHS, the Promoting Ethnic Diversity in Public Health Research Education project, Rackham Merit Fellowship or the Rackham Faculty Allies program. This analysis was also supported by the Aetna Foundation, a National Foundation based in Hartford, Connecticut, that supports projects to promote wellness, health and access to high quality health care for everyone. The views presented here are those of the authors, and not necessarily those of the Aetna Foundation, its directors, officers or staff.


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Copyright information

© The New York Academy of Medicine 2017

Authors and Affiliations

  • Jamila L. Kwarteng
    • 1
  • Amy J. Schulz
    • 2
  • Graciela B. Mentz
    • 2
  • Barbara A. Israel
    • 2
  • Denise White Perkins
    • 3
  1. 1.Medical College of WisconsinMilwaukeeUSA
  2. 2.University of Michigan, School of Public HealthAnn ArborUSA
  3. 3.Henry Ford Health System, Institute on Multicultural HealthDetroitUSA

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