Study objective: This study examined the prevalence of body dissatisfaction as a function of individual level and neighbourhood level indicators of affluence.
Participants and setting: A subset of data from a larger random digit dialling telephone survey was used to obtain individual level data on body dissatisfaction, body weight and height, and income from a group of 895 adult women (age 24–56, 61% English speaking) living in 52 neighbourhoods (census tract areas) within the provinces of Alberta, Ontario, and Quebec, Canada who were selected for their heterogeneity in social class.
Design: Aggregated census tract data from 1996 were used to develop neighbourhood indicators of affluence. Using hierarchical linear modelling, body dissatisfaction (dichotomous) was examined as a function of individual body mass index, individual level affluence and neighbourhood level affluence.
Main results: The impact of body mass index on body dissatisfaction depended on the level of neighbourhood affluence: an average body mass index was associated with higher likelihood of reporting body dissatisfaction in a neighbourhood of above average affluence (71% probability) than in a neighbourhood of average affluence (58% probability), independent of a woman's individual affluence (whether she was low income or not).
Conclusion: It is concluded that a clearer understanding of the role of affluence on body dissatisfaction can be achieved by a joint examination of individual and neighbourhood level influences.
- body dissatisfaction
- small area effects
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↵* An independent samples t test indicated that women with complete data on “income” and “body mass index” did not differ on “body dissatisfaction” (our outcome variable) from those women with missing data on either or both of these two variables (t (1627)=−0.861, p=0.71). Furthermore, a χ2 test indicated that patterns of missing data on body mass index (n=167) and on body dissatisfaction (n=22) were random across neighbourhoods (χ2 (52)=63.99, p=0.12 for body mass index; χ2 (52)=33.98, p=0.98 for body dissatisfaction).
↵† The majority of the “dissatisfied” women reported “wanting to lose weight” (93%). We ran analyses with and without those who reported “wanting to gain weight” (7%); results did not differ and thus results based on data from all women were retained.
↵‡ We re-ran analyses using an alternative measure of body dissatisfaction for the outcome variable: discrepancy between ideal and actual weight. Results from these analyses were consistent with those reported in the text; namely, neighbourhood affluence emerged as a marginally significant predictor (p=0.055) of a variable relation between body mass index and actual-ideal discrepancy.
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