Alaba Olufunke, Chola Lumbwe
Health Economics Unit, School of Public Health and Family Medicine, University of Cape Town, Cape Town 7925, South Africa.
PRICELESS SA, MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, University of the Witwatersrand, Johannesburg 2050, South Africa.
Int J Environ Res Public Health. 2014 Mar 21;11(3):3387-406. doi: 10.3390/ijerph110303387.
In recent years, there has been a dramatic increase in obesity in low and middle income countries. However, there is limited research in these countries showing the prevalence and determinants of obesity. In this study, we examine the socioeconomic inequalities in obesity among South African adults. We use nationally representative data from the South Africa National Income Dynamic Survey of 2008 to: (1) construct an asset index using multiple correspondence analyses (MCA) as a proxy for socioeconomic status; (2) estimate concentration indices (CI) to measure socioeconomic inequalities in obesity; and (3) perform a decomposition analysis to determine the factors that contribute to socioeconomic related inequalities. Consistent with other studies, we find that women are more obese than men. The findings show that obesity inequalities exist in South Africa. Rich men are more likely to be obese than their poorer counterparts with a concentration index of 0.27. Women on the other hand have similar obesity patterns, regardless of socioeconomic status with CI of 0.07. The results of the decomposition analysis suggest that asset index contributes positively and highly to socio-economic inequality in obesity among females; physical exercise contributes negatively to the socio-economic inequality. In the case of males, educational attainment and asset index contributed more to socio-economic inequalities in obesity. Our findings suggest that focusing on economically well-off men and all women across socioeconomic status is one way to address the obesity problem in South Africa.
近年来，低收入和中等收入国家的肥胖率急剧上升。然而，这些国家关于肥胖症患病率及其决定因素的研究有限。在本研究中，我们调查了南非成年人肥胖问题中的社会经济不平等情况。我们使用2008年南非国民收入动态调查的全国代表性数据来：（1）通过多重对应分析（MCA）构建一个资产指数，作为社会经济地位的替代指标；（2）估计集中指数（CI）以衡量肥胖问题中的社会经济不平等；（3）进行分解分析，以确定导致社会经济相关不平等的因素。与其他研究一致，我们发现女性比男性更肥胖。研究结果表明，南非存在肥胖不平等现象。富有的男性比贫穷男性更易肥胖，集中指数为0.27。另一方面，女性无论社会经济地位如何，肥胖模式相似，集中指数为0.07。分解分析结果表明，资产指数对女性肥胖问题中的社会经济不平等有正向且高度显著的贡献；体育锻炼对社会经济不平等有负向贡献。对于男性而言，教育程度和资产指数对肥胖问题中的社会经济不平等贡献更大。我们的研究结果表明，关注经济状况良好的男性以及不同社会经济地位的所有女性是解决南非肥胖问题的一种途径。
