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Naimi, Ashley Isaac; Paquet, Catherine; Gauvin, Lise; & Daniel, Mark (2009). Associations between Area-Level Unemployment, Body Mass Index, and Risk Factors for Cardiovascular Disease in an Urban Area [Open Access]. International Journal of Environmental Research and Public Health, 6(12), 3082-3096. PMCID: PMC2800335


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.


Reference Type

Journal Article

Year Published


Journal Title

International Journal of Environmental Research and Public Health


Naimi, Ashley Isaac
Paquet, Catherine
Gauvin, Lise
Daniel, Mark