Psychological and biological pathways linking perceived neighborhood characteristics and body mass index

Background: Perceived neighborhood characteristics are linked to obesity, however, the mechanisms linking these two factors remain unknown. Purpose: This study aimed to examine associations between perceived neighborhood characteristics and body mass index (BMI), establish whether indirect pathways through psychological distress and inflammation are important, and determine whether these associations vary by race/ethnicity. Methods: Participants were 1,112 adults enrolled in the Texas City Stress and Health Study. Perceived neighborhood characteristics were measured using the Perceived Neighborhood Scale. Psychological distress was measured with the Center for Epidemiological Studies Depression Scale, Perceived Stress Scale and mental health subscale of the Short Form Health Survey-36. Markers of inflammation included C-reactive protein, interleukin-6, and tumor necrosis factor receptor-1. Associations were examined with Structural Equation Modeling. Results: A model linking neighborhood characteristics with BMI through direct and indirect (i.e., psychological distress and inflammation) paths demonstrated good fit with the data. Less favorable perceived neighborhood characteristics were associated with greater psychological distress (B = -0.87, β = -0.31, p <. 001) and inflammation (B = -0.02, β = -0.10, p =. 035). Psychological distress and inflammation were also significantly associated with BMI (B_distress = 0.06, β = 0.08, p =. 006; B_inflammation = 4.65, β = 0.41, p <. 001). Indirect paths from neighborhood characteristics to BMI via psychological distress (B = -0.05, β = -0.03, p =. 004) and inflammation (B = -0.08, β = -0.04, p =. 045) were significant. In multiple group analysis, a model with parameters constrained equal across race/ethnicity showed adequate fit suggesting associations were comparable across groups. Conclusion: Our study extends the literature by demonstrating the importance of neighborhood perceptions as correlates of BMI across race/ethnicity, and highlights the role of psychological and physiological pathways.