The association between social cohesion in the neighborhood and body mass index (BMI): An examination of gendered differences among urban-dwelling Canadians

Overweight and obesity are major global public health concerns. Obesity is multifactorial in origin and influenced by genetics, psychosocial factors, eating and physical activity behaviors, as well as the environment. The objective of this study is to examine the impact of social cohesion on gender differences in body mass index (BMI) for urban-dwelling Canadians. Cross-sectional data were used from the Neighborhood Effects on Health and Well-being Study (NEHW) in Toronto, Canada (n = 2300). Our main outcome, BMI, was calculated from self-reported height and weight (weight (kg)/height (m)²). Using multi-level logistic regression models, we identified a significant interaction between social cohesion and gender on being overweight/obese. Women with higher social cohesion had slightly lower odds of being overweight/obese (OR: 0.96, 95%CI: 0.94 to 0.99) compared to men, after adjusting for other sociodemographic factors (e.g., age, income, education), and neighborhood characteristics (e.g., walkability, neighborhood safety and material deprivation). Future public health research and interventions should consider the differential mechanisms involved in overweight/obesity by gender. The exact mechanisms behind how the social environment influences these pathways are still unclear and require future research.