Child overweight and undernutrition in Thailand: Is there an urban effect?
Child overweight and undernutrition in Thailand: Is there an urban effect?
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DOI：
10.1016/j.socscimed.2011.03.003
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发表时间：
2011-05-01
影响因子：
5.4
通讯作者：
Gortmaker, Steven L.
中科院分区：
文献类型：
--
作者：
Firestone, Rebecca;Punpuing, Sureeporn;Gortmaker, Steven L.
在许多发展中国家，城市在儿童营养不良风险较低方面具有优势，但儿童肥胖症在城市地区往往比农村地区更为普遍。这项研究的目的是评估城乡营养不良和肥胖症的差异是否归因于社会经济地位低下的儿童集中在城市社区或城市环境的具体方面。4610名2-10岁儿童的样本来自2004年一轮的坎恰纳布里人口监测系统，监测健康和人口变化的坎恰纳布里省，泰国。我们使用多水平逻辑回归来模拟102个社区的儿童身材矮小、体重不足和肥胖的几率。模型测试了儿童的社会经济条件是否是城乡差异的原因，或者社会和物质环境的各个方面是否是差异的原因，并根据儿童的特点进行了调整。27.8%的儿童体重不足，19.9%的儿童身材矮小，8.3%的儿童肥胖。双变量关联显示，城市居住与较低的营养不良风险和较高的肥胖风险相关。城市和农村的矮小和体重不足的几率差异是由儿童的社会经济特征造成的。在调整儿童特征后，城市居住仍然是肥胖的危险因素。社区财富集中度、电视覆盖率和卫生设施覆盖率与肥胖风险增加独立相关。营养不良与家庭贫困密切相关，而家庭富裕和城市环境的特点与肥胖的几率有关。需要进一步研究，以确定城市环境如何导致发展中国家儿童的肥胖风险。(C)2011爱思唯尔有限公司保留所有权利。
An urban advantage in terms of lower risk of child undernutrition has been observed in many developing countries, but child obesity is often more prevalent in urban than rural areas. This study aimed to assess whether urban-rural disparities in undernutrition and obesity were attributable to concentrations of socioeconomically advantaged children into urban communities or to specific aspects of the urban environment. A sample of 4610 children ages 2-10 years was derived from the 2004 Round of the Kanchanaburi Demographic Surveillance System, monitoring health and demographic change in the province of Kanchanaburi, Thailand. We used multi-level logistic regression to model the odds of short stature, underweight, and obesity for children in 102 communities. Models tested whether child socioeconomic conditions accounted for urban-rural disparities or if aspects of the social and physical environment accounted for disparities, adjusting for child characteristics. 27.8% of children were underweight, while 19.9% had short stature, and 8.3% were obese. Bivariate associations showed urban residence associated with lower risk of undernutrition and a greater risk of obesity. Urban-rural disparities in odds of short stature and underweight were accounted for by child socioeconomic characteristics. Urban residence persisted as a risk factor for obesity after adjusting for child characteristics. Community wealth concentration, television coverage, and sanitation coverage were independently associated with greater risk of obesity. Undernutrition was strongly associated with household poverty, while household affluence and characteristics of the urban environment were associated with odds of obesity. Further research is needed to characterize how urban environments contribute to children's risks of obesity in developing countries. (C) 2011 Elsevier Ltd. All rights reserved.