Neighbourhood characteristics and cumulative biological risk: evidence from the Jamaica Health and Lifestyle Survey 2008: a cross-sectional study

ObjectiveTo examine whether neighbourhood characteristics are associated with cumulative biological risk (CBR) and sex differences in CBR in a nationally representative sample in Jamaica, a small island developing country with increasing prevalence of non-communicable diseases (NCDs).DesignCross-sectional studySettingA population-based cross-sectional survey, the Jamaica Health and Lifestyle Survey 2008 (JHLS II) recruited persons at their homes over a 4 month period from all 14 parishes and 113 neighbourhoods defined as enumeration districts (EDs).Participants2544 persons aged 15–74 years old from the 2008 Jamaica Health and Lifestyle Survey (JHLS II), who completed interviewer-administered questionnaires and had biomarkers assessed, and whose home addresses could be reliably geocoded.Primary outcomeA summary measure CBR was created using seven markers—systolic and diastolic blood pressure readings, waist circumference, body mass index, total cholesterol, fasting blood glucose levels and self-reported asthma. Weighted multilevel models examined clustering, using the intraclass correlation coefficient (ICC), of CBR across neighbourhoods and the impact of neighbourhood characteristics (recreational space availability and neighbourhood disorder) on CBR.ResultsWomen had significantly higher mean CBR scores than men across all age groups. There was significant clustering of CBR by ED, and among women versus men (ICC: F=6.9%, M=0.7%). Women living in more disordered neighbourhoods were 26% more likely to have high CBR as those in less disordered ones (aOR=1.26, 95% CI=1.08 to 1.47; p