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

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 neighbourbood 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.