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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2009 Jan 1;100(1):18–23. doi: 10.1007/BF03405486

The Geography of Overweight in Quebec: A Multilevel Perspective

Alexandre Lebel 16,26,✉, Robert Pampalon 26, Denis Hamel 26, Marius Thériault 16
PMCID: PMC6973975  PMID: 19263970

Abstract

Objectives

Explore the contextual aspects of overweight in Québec through multilevel modelling, using a purposely designed set of spatial units and a few area-based characteristics.

Methods

Data came from the Canadian Community Health Survey (CCHS Cycle 2.1). Multilevel logistic regressions were performed to test for the presence of an independent contextual effect on overweight and obesity (BMI >-25 kg/m2), separately for men and women. Modelling considered individual attributes, including some lifestyle aspects, and contextual characteristics. A geographic grid integrating spatial elements related to overweight and obesity in the literature was developed. Also, an area-level residuals analysis was carried out to identify spatial units presenting higher or lower odds of being overweight.

Results

After accounting for individual and area-level characteristics, there remain significant geographic variations in overweight in Québec. Although this contextual effect is small for men and women, many spatial units differ significantly from the provincial average. There are differences between the geography of overweight in men and women which suggest that socio-economic mechanisms and land use patterns underlying overweight might be different between genders. Also, there is considerable variability within rural and urban areas.

Conclusion

A complex geography of overweight is revealed. Small-scale studies, as well as methodological and data developments, are needed to deepen our understanding of this geography.

Key words: Overweight, obesity, Québec, medical geography, multilevel analysis, population health

Footnotes

Acknowledgements: This research could not have been carried out without the financial support of the Quebec Population Health Research Network (QPHRN), the Quebec Inter-University Centre for Social Statistics (QICSS), and the Fonds de la recherche en santé du Québec (FRSQ). The Institut national de santé publique du Québec (INSPQ) and the Natural Science and Engineering Research Council of Canada (NSERCC) also contributed to this study. Finally, we thank William Pederson and Pierre Masson for their revision of an earlier version of this manuscript, as well as Philippe Gamache and Patricia Lamontagne, both from INSPQ, for their valuable advice.

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