Weight abnormalities (underweight, overweight, and obesity) can cause life-threatening ailments. This study investigates disparities in the prevalence of underweight, overweight, and obesity between northern and southern Nigeria and their associated factors. Using the 2018 Nigeria Demographic and Health Survey (NDHS), the study analysed a sample of 12,333 women with complete records of body mass index. The study found that southern women had lower odds of being underweight than women in the north, but the reverse was the case for overweight and obesity. The prevalence of underweight was 11.6%, and it varies from 6.9% in the southern state of Enugu to 31.6% in the northern state of Jigawa. The national prevalence of overweight was 17.9%, ranging from 6.7% in Jigawa State of the northern region to 39.9% in Lagos State of the south. Similarly, the prevalence of obesity in the north was 6.1% compared to 14.4% in the south, with Anambra State of the southern region recording the highest figure of 35.5% compared to 2.1% in the Yobe State of the northern region. In all, the rate of abnormal weight was significantly higher in the south than in the north. However, the type of weight abnormality varies between the two regions. Religion, education, use of contraceptives, and wealth were associated with the three forms of abnormal weights. However, while religion was significantly associated with obesity in the north, the association was not significant in the south. This study found that wealth and education have dissimilar influences on overnutrition. While the odds of being overweight and obese increase with wealth, being educated up to a secondary level significantly reduces the odds in Nigeria and across the two regions.
]]>Numerous studies have confirmed the relationship between individual risk and time preference and obesity. Nevertheless, none has studied the effect of these attitudes on chronic (long-term) obesity. This study used Indonesia Family Life Survey (IFLS) data from 16,366 individuals. It tracked their obesity status in 2007 and 2014 by calculating body mass index, the ratio between body weight and square of height. Besides the conventional risk-averse and risk-tolerant behaviour, the IFLS sample includes people who fear uncertainty related to the status quo bias. The ordered logit regression results show that past impatience, risk tolerance, and status quo bias behaviour (in 2007) are associated with transient or chronic obesity, while only current behaviour of status quo bias (in 2014) is associated with obesity. Furthermore, our study confirms that chronic obesity in Indonesia is prevalent among highly educated, high-income, and urban-centric individuals, exacerbated by impatience, risk tolerance, and uncertainty aversion. Thus, providing information on the risk of obesity and food calories, giving the incentive to avoid obesity, and improving the quality of built environments such as public parks, public transportation, and footpath could help prevent the rising obesity prevalence.
]]>India has not only maintained its top position among countries with the largest number of underweight adults but has also jumped to a higher position among countries with largest increase in the proportion of overweight people in the last three decades. More studies focus on double burden of malnutrition among women than on men. This study uses the quantile regression model to analyse the covariates associated with low and high body mass index (BMI) primarily among men aged 20–54 years during 2015–2016 in India. Occupations that involve more manual work help in maintaining a normal BMI along with better education, dietary diversity, and less sedentary lifestyle. A gendered comparison of men and their spouses highlights the differences in the association of covariates with BMI for men and women. The results from this study will provide insights for behavioural change at an individual level and inputs for public health intervention for addressing ill health concerns arising from underweight, overweight, or obesity.
]]>Considered the epidemic of the 21st century by the WHO, obesity is a global problem that is on the rise and will continue to increase in the coming years. Spain and Andalusia, in particular, are no exception to this pathology, which has tripled since the 1970s, representing a public health challenge. The aim of this study is to analyse the socioeconomic determinants of this pathology, with special emphasis on answering the question of what has a greater influence on overweight, education level, or income. For this purpose, we have used the European Survey of Health in Spain (ESHS-2020), a microdata base, with a total of 22,072 valid individual observations (of which 2,820 belong to the Andalusian population). Results we obtain in our estimations of qualitative response models reveal that, although both income and educational attainment could be effective in the fight against overweight, the social gradient of this health problem is greater with respect to educational attainment. Additionally, there are many other variables and other factors related to the individual’s overweight (mental health, subjective state of health, oral health, among others) which are much less explored and which must be considered in health policies to combat this disease.
]]>Nutritional impairment during adolescence may result in adverse physical and reproductive health outcomes. We investigated the prevalence and determined the factors associated with underweight and overweight/obesity among ever-married adolescent girls in Bangladesh. We used Bangladesh Demographic and Health Surveys data conducted in 2004, 2007, 2011, 2014, and 2017. A total of 7040 ever-married adolescent girls aged 15–19 years were included in this analysis. Prevalence of underweight (body mass index [BMI]<18.5 kg/m2) significantly decreased from 39.53% (95% CI = 36.71, 42.43) to 23.62% (95% CI = 21.35, 26.05) during 2004–2017 (p < 0.001). However, prevalence of overweight/obesity (BMI ≥ 23 kg/m2) significantly increased from 5.9% (95% CI = 4.67, 7.43) to 22.71% (95% CI = 20.39, 25.20) during the same period (p < 0.001). The girls with higher age (OR = 0.94, 95% CI = 0.90, 0.99, p = 0.023), higher level of education (OR = 0.60, 95% CI = 0.43, 0.83, p = 0.002), and richest wealth quintile (OR = 0.78, 95% CI = 0.62, 0.98, p = 0.035) had significantly lower risk of being underweight. Adolescent girls having more than one child (OR = 1.41, 95% CI = 1.15, 1.73, p = 0.001) were more likely to be underweight. Elderly adolescents with better economic status were more at risk of being overweight/obese (OR = 2.57, 95% CI = 1.86, 3.55, p < 0.001). Girls married to skilled/unskilled workers (OR = 0.58, 95% CI = 0.44, 0.77, p < 0.001) and persons involved in small businesses (OR = 0.66, 95% CI = 0.49, 0.89, p = 0.007) had lower risk of having a high BMI. Using contraceptive (OR = 0.8, 95% CI = 0.69, 0.94, p = 0.006) was negatively associated with overweight/obese. Although prevalence of undernutrition among ever-married adolescent girls is declining, the proportion of being overweight/obese is increasing in Bangladesh warranting effective strategies to improve adolescent nutrition.
]]>Adolescence is a unique transitional stage of physical and psychological development. As preferences and behavioural choices adopted in adolescence influence lifelong physical activity habits and health outcomes in adulthood, rural transformation in low- and middle-income countries has the potential to significantly change traditional roles and shape the next generation. By using a mixed-method approach that integrates energy expenditure estimates from accelerometer devices with 24-hour recall time-use data from adolescent boys and girls and qualitative interviews with adolescents and their caregivers, this study sheds light on the patterns of quantity and quality of physical activity of 395 adolescents in Khammam and Mahbubnagar districts of rural Telangana, India. The study shows that energy expenditure and time use are highest for educational-related activities followed by leisure in both adolescent boys and girls. However, notwithstanding the process of rural transformation and the educational infrastructure and economic opportunities provided to adolescent boys and girls, social and cultural norms allow boys, especially in late adolescence to spend more time and energy in activities outside the home such as pursuing economic work, sports and socialising, while girls spend more time and energy at home doing domestic work. The quantitative and qualitative exploration of physical activity and time use among adolescents, as expounded in this study cutting across age groups and gender, highlights the need for changes in gendered norms and renewed government strategies and investments in that direction.
]]>In India, undernutrition among children has been extremely critical for the last few decades. Most analyses of undernutrition among Indian children have used the administrative boundaries of a state or a district level as a unit of analysis. This paper departs from such a practice and focuses instead on the political boundaries of a parliamentary constituency (PC) as the unit of analysis. The PC is a critical geopolitical unit where political parties and party candidates make election promises and implement programmes to improve the socio-economic condition of their electorate. A focus on child undernutrition at this level has the potential for greater policy and political traction and could lead to a paradigm shift in the strategy to tackle the problem by creating a demand for political accountability. Different dimensions and new approaches are also required to evaluate the socio-economic status and generate concrete evidence to find solutions to the problem. Given the significance of advanced analytical methods and models embedded into geographic information system (GIS), the current study, for the first time, uses GIS tools and techniques at the PC level, conducting in-depth analysis of undernutrition and its predictors. Hence, this paper examines the spatial heterogeneity in undernutrition across PCs by using geospatial techniques such as univariate and bivariate local indicator of spatial association and spatial regression models. The analysis highlights the high–low burden areas in terms of local hotspots and identifies the potential spatial risk factors of undernutrition across the constituencies. Striking variations in the prevalence of undernutrition across the constituencies were observed. Most of these constituencies that performed poorly both in terms of child nutrition and socio-economic indicators were located in the northern, western, and eastern parts of India. A statistically significant association of biological, socio-economic, and environmental factors such as women’s body mass index, anaemia in children, poverty, household sanitation facilities, and institutional births was established. The results highlight the need to bring in a mechanism of political accountability that directly connects elected representatives to maternal and child health outcomes. The spatial variability and pattern of undernutrition indicators and their correlates indicate that priority setting in research may also be greatly influenced by the neighbourhood association.
]]>While social determinants of health have been perennially linked to child survival in resource-limited countries, the precise and tested pathways to effect are not clearly understood. The objective of this study was therefore to identify the critical pathways as posited a priori in a model through which social factors (at maternal, household, and community levels) determine neonatal, infant, and under-five mortalities in Nigeria. Using a novel analytic approach (hierarchical path modelling for predicting accelerated failure time) to estimate (in)direct and total effects of social determinants of child survival, we analysed 30,960 live births (weighted data for representativeness), obtained from the 2016/2017 Nigeria Multiple Indicator Cluster Survey. There were three outcome variables: time until occurrence of neonatal, infant, and under-five mortalities. The independent variables were layered factors related to child, maternal, household and community. Geographical region, rurality of residence, infrastructural development, maternal education, contraceptive use, marital status, and maternal age at birth were found to operate more indirectly on neonatal, infant, and under-five survival. Child survival is due to direct effects of child’s sex (female), gestational type (singleton), birth spacing (children whose mothers delivered at least two years apart), and maternal age at delivery (20–34 years). According to the path coefficients, the indirect effects of geographical regions are the most influential determinants of child survival, accounting for 30% (neonatal), 37.1% (infant) and 39.9% (under-five) of the total effects. This study offers comprehensive set of factors, and linked pathways, at the maternal, household, and community levels that are associated with child survival in Nigeria. To accelerate progress towards Sustainable Development Goal targets for child survival and reduce geographical inequities, stakeholders should implement more impactful policies that promote maternal education, contraceptive use and improve living conditions of women (especially in rural areas of northern Nigeria). Future research should focus on identifying the most effective interventions for addressing these social determinants of child survival in Nigeria.
]]>The aim of this study was to understand the perspectives of female residents of Spain from West Africa in terms of the factors that condition their lives. Pierre Bourdieu’s theory and the model of intersectionality formed the framework we used to qualitatively analyse the life stories of these women, which was complemented with life lines. The results showed us that traditional practices such as female genital mutilation and forced marriage are part of the social habitus of this group and they relate to each other through the several types of violence that occurs throughout their lives. In addition, in reference to the African community, these women were no longer African, while in terms of the Spanish community, they did not seem Spanish. At a health, political, and social level, this knowledge can help us to understand this group and to create personalised targeted interventions for them.
]]>As the proportion of women being victims of spousal violence in India is higher than men, laws are usually framed to safeguard women. However, men who have experienced physical spousal violence are not unheard of. The study aims to provide the nationwide prevalence of physical violence against husbands and the risk factors for such violence, using large-scale nationally representative ‘National Family Health Survey’ (NFHS 4) data. The study used descriptive, bivariate, logistic, and multilevel regression models with a random intercept clustering within states and households to explain the physical violence against husband. Sample size for the analysis was 62,716 currently married women aged 15–49 years. Findings revealed that in most of the states of India, physical spousal violence has increased over time. Behavioural characteristics like marital control, alcoholism, and childhood experience of parental violence have a consistent and strong role in explaining the experience of physical violence across states. With age, experience of violence against husbands increases. Differences in socio-economic characteristics do not have unidirectional effect on violence experienced by husbands across regions of India. Working women who are earning cash and having access to mobile phones perpetrate more physical violence in selected regions. Education shows a gradient on such violence perpetration, indicating that only after achieving a certain level of education, chances of violence reduce. Regionally contrasting social and economic risk factors in explaining violence strengthen the argument that violence is space and culture-specific, and development alone may not resolve violence unless the system is addressing the behavioural aspects. There is a need for supporting men experiencing domestic violence within the existing system facilities. Revisiting the present domestic violence laws and programmes for inclusivity is the need of the hour.
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