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Separate and combined effects of individual and neighbourhood socio-economic disadvantage on health-related lifestyle risk factors: a multilevel analysis

24 April 2021

​Yinjie Zhu, Ming-Jie Duan, Ineke J Riphagen, Isidor Minovic, Jochen O Mierau, Juan-Jesus Carrero, Stephan JL Bakker, Gerjan J Navis, Louise H Dekker

Healthy lifestyle is key to the prevention of type 2 diabetes. In this research, we found that both individual socio-economic disadvantage (ISED) and neighborhood socio-economic disadvantage (NSED) were both positively associated with practicing an unhealthy lifestyle (lifestyle risk index). More importantly, the association between ISED and the lifestyle risk index was positively modified by NSED, from which a “double jeopardy” effect was observed: for people who were individually socio-economically disadvantaged, they were more likely to practice an unhealthy lifestyle if they lived in socio-economically disadvantaged neighborhoods. Our findings suggest that public health initiatives addressing lifestyle-related socio-economic differences should not only target individuals, but also consider neighborhood-level contextual factors.

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