Associations between area-level unemployment, body mass index, and risk factors for cardiovascular disease in an urban area

Int J Environ Res Public Health. 2009 Dec;6(12):3082-96. doi: 10.3390/ijerph6123082. Epub 2009 Dec 4.


Introduction: Cardiovascular Disease (CVD) has been linked to "neighbourhood" socioeconomic status (nSES), often operationalized as a composite index of aggregate income, occupation and education within predefined administrative boundaries. The role of specific, non-composite socioeconomic markers has not been clearly explained. It is also unclear whether the relationship between nSES and CVD varies according to sex. We sought to determine whether area-level unemployment (ALU) was associated with CVD risk, and whether this association differed by sex.

Methods: 342 individuals from the Montreal Neighbourhood Survey of Lifestyle and Health provided self-reported behavioural and socioeconomic information. A nurse collected biochemical and anthropometric data. ALU, a weighted average of the proportion of persons 15-years and older available for but without work, was measured using a Geographic Information System for a 250 m buffer centred on individual residence. Generalized Estimating Equations were used to estimate the associations between ALU, body mass index (BMI) and a cumulative score for total cardiometabolic risk (TCR).

Results: After confounder adjustments, the mean 4(th) minus 1(st) quartile difference in BMI was 3.19 kg/m(2) (95% CI: 2.39, 3.99), while the prevalence ratio for the 4(th) relative to 1(st) quartile for TCR was 2.20 (95 % CI: 1.53, 3.17). Sex interacted with ALU; women relative to men had greater mean 3.97 kg/m(2) (95% CI: 2.08, 5.85) BMI and greater mean TCR 1.51 (95% CI: 0.78, 2.90), contrasted at mean ALU.

Conclusions: Area-level unemployment is associated with greater CVD risk, and this association is stronger for women.

Keywords: cardiovascular diseases; neighbourhood; residence characteristics; unemployment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Glucose
  • Body Mass Index*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Confidence Intervals
  • Female
  • Geographic Information Systems
  • Health Behavior
  • Health Surveys
  • Humans
  • Life Style
  • Lipids / blood
  • Male
  • Middle Aged
  • Odds Ratio
  • Quebec / epidemiology
  • Residence Characteristics / statistics & numerical data*
  • Risk Assessment
  • Risk Factors
  • Socioeconomic Factors
  • Stress, Psychological*
  • Surveys and Questionnaires
  • Unemployment / statistics & numerical data*
  • Urban Population / statistics & numerical data*
  • Young Adult


  • Blood Glucose
  • Lipids