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      Neighbourhood level versus individual level correlates of women's body dissatisfaction: toward a multilevel understanding of the role of affluence.

      Journal of Epidemiology and Community Health
      Adult, Alberta, Attitude to Health, Body Height, Body Image, Body Mass Index, Body Weight, Female, Humans, Income, Middle Aged, Ontario, Quebec, Residence Characteristics, Social Class, Women, psychology

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          This study examined the prevalence of body dissatisfaction as a function of individual level and neighbourhood level indicators of affluence. 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. 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. 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). 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.

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