Obesity and inequities in health in the developing world
Obesity and inequities in health in the developing world
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DOI：
10.1038/sj.ijo.0802716
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发表时间：
2004-09-01
影响因子：
4.9
通讯作者：
Popkin, BM
中科院分区：
文献类型：
--
作者：
Monteiro, C;Conde, WL;Popkin, BM
目的：更新发展中国家妇女肥胖的社会分布情况，特别是确定发展中国家妇女肥胖开始加剧健康不平等的具体经济发展水平。设计：多层次逻辑回归分析应用于人体测量和社会经济数据收集的全国代表性的交叉，1992年至2000年在世界各区域和经济发展阶段的37个发展中国家进行的部门调查（人均国民生产总值（GNP）从190美元到4440美元）。受试者：总共148579名年龄在20-49岁的非怀孕妇女。身体质量指数，以评估肥胖状况;四分位数的教育年来评估妇女的社会经济地位（SES），和人均国民生产总值，以评估国家的阶段的economic development.RESULTS：属于较低的SES组赋予强大的保护，防止肥胖在低收入的经济体，但它是一个系统的危险因素，在中上收入的发展中经济体的疾病。一个多层次的逻辑模型--包括一个国家的国民生产总值和每个妇女的社会经济地位指数之间的相互作用项--表明，当国民生产总值达到人均2500美元左右时，肥胖开始加剧发展中国家的健康不平等。对于大多数中上收入经济体和部分中低收入经济体来说，成年女性的肥胖已经是健康不平等的一个相关助推器，如果没有协调一致的国家公共行动来预防肥胖，经济增长将大大增加出现这种情况的发展中国家的名单。
OBJECTIVE: To update the social distribution of women's obesity in the developing world and, in particular, to identify the specific level of economic development at which, if any, women's obesity in the developing world starts to fuel inequities in health.DESIGN: Multilevel logistic regression analyses applied to anthropometric and socioeconomic data collected by nationally representative cross-sectional surveys conducted from 1992 to 2000 in 37 developing countries within a wide range of world regions and stages of economic development (gross national product (GNP) from US$190 to 4440 per capita).SUBJECTS: In total, 148 579 nonpregnant women aged 20-49 y.MEASUREMENTS: Body mass index to assess obesity status; quartiles of years of education to assess woman's socioeconomic status (SES), and GNP per capita to assess country's stage of economic development.RESULTS: Belonging to the lower SES group confers strong protection against obesity in low-income economies, but it is a systematic risk factor for the disease in upper-middle income developing economies. A multilevel logistic model-including an interaction term between the country's GNP and each woman's SES-indicates that obesity starts to fuel health inequities in the developing world when the GNP reaches a value of about US$2500 per capita.CONCLUSIONS: For most upper-middle income economies and part of the lower-middle income economies, obesity among adult women is already a relevant booster of health inequities and, in the absence of concerted national public actions to prevent obesity, economic growth will greatly expand the list of developing countries where this situation occurs.