D.L. Dahly, P. Gordon-Larsen, M. Emch, J. Borja, L.S. Adair
OBJECTIVES: The objectives of the study were to test for spatial clustering of obesity in a cohort of young adults in the Philippines, to estimate the locations of any clusters, and to relate these to neighborhood-level urbanicity and individual-level socioeconomic status (SES). SUBJECTS: Data are from a birth cohort of young adult (mean age 22 years) Filipino males (n=988) and females (n=820) enrolled in the Cebu Longitudinal Health and Nutrition Survey. METHODS: We used the Kulldorff spatial scan statistic to detect clusters associated with unusually low or high prevalences of overweight or obesity (defined using body mass index, waist circumference and body fat percentage). Cluster locations were compared to neighborhood-level urbanicity, which was measured with a previously validated scale. Individual-level SES was adjusted for using a principal components analysis of household assets. RESULTS: High-prevalence clusters were typically centered in urban areas, but often extended into peri-urban and even rural areas. There were also differences in clustering by both sex and the measure of obesity used. Evidence of clustering in males, but not females, was much weaker after adjustment for SES © 2013 Macmillan Publishers Limited.
Centre for Epidemiology and Biostatistics, University of Leeds, Leeds LS2 9JT, Worsley Building, 8.001, United Kingdom; Carolina Population Center, Chapel Hill, NC, United States; Department of Nutrition, University of North Carolina, Chapel Hill, NC, United States; Department of Geography, University of North Carolina, Chapel Hill, NC, United States; University of San Carlos, Office of Population Studies, Cebu City, Philippines
