Department of Community Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.
Centre for Tropical Medicine, University of Oxford, Oxford, UK.
Int J Equity Health. 2015 Jan 17;14:6. doi: 10.1186/s12939-015-0140-8.
Obesity is an increasing problem in South Asian countries and Sri Lanka is no exception. The socioeconomic determinants of obesity in Sri Lanka, and in neighbouring countries are inadequately described. Aim was to describe social, cultural and economic determinants of obesity in a representative sample from Kalutara District in Sri Lanka.
This was a cross sectional descriptive study conducted among adults aged 35-64 years. A representative sample was selected using stratified random cluster sampling method from urban, rural and plantation sectors of Kalutara District. Data were collected using a pre-tested questionnaire. A body mass index of 23.01 kg/m(2)-27.50 kg/m(2) was considered as overweight and ≥27.51 kg/m(2) as obese. Waist circumference (WC) of ≥ 90 cm and ≥80 cm was regarded as high for men and women respectively. Significance of prevalence of obesity categories across different socio-economic strata was determined by chi square test for trend.
Of 1234 adults who were screened, age and sex adjusted prevalence of overweight, obesity and abdominal obesity (high WC) were 33.2% (male 27.3%/female 38.7%), 14.3% (male 9.2%/female 19.2%) and 33.6% (male 17.7%/female 49.0%) respectively. The Muslims had the highest prevalence of all three obesity categories. Sector, education, social status quintiles and area level deprivation categories show a non linear social gradient while income shows a linear social gradient in all obesity categories, mean BMI and mean WC. The differences observed for mean BMI and mean WC between the lowest and highest socioeconomic groups were statistically significant.
There is a social gradient in all three obesity categories with higher prevalence observed in the more educated, urban, high income and high social status segments of society. The higher socioeconomic groups are still at a higher risk of all types of obesity despite other public health indicators such as maternal and infant mortality displaying an established social gradient.
肥胖是南亚国家日益严重的问题，斯里兰卡也不例外。斯里兰卡和邻国的肥胖症社会经济决定因素描述不足。本研究旨在描述斯里兰卡卡卢特勒区代表性样本中肥胖的社会、文化和经济决定因素。
这是一项横断面描述性研究，对象为 35-64 岁的成年人。采用分层随机聚类抽样法，从卡卢特勒区的城市、农村和种植园部门选取有代表性的样本。使用经过预测试的问卷收集数据。体重指数为 23.01kg/m(2)-27.50kg/m(2)被认为超重，≥27.51kg/m(2)为肥胖。腰围（WC）≥90cm 和≥80cm 分别被认为是男性和女性的高值。通过卡方检验趋势，确定不同社会经济阶层肥胖类别流行率的显著性。
在筛选出的 1234 名成年人中，经年龄和性别调整后，超重、肥胖和腹型肥胖（WC 高值）的流行率分别为 33.2%（男性 27.3%/女性 38.7%）、14.3%（男性 9.2%/女性 19.2%）和 33.6%（男性 17.7%/女性 49.0%）。穆斯林的三种肥胖类型的流行率最高。部门、教育、社会地位五分位数和地区贫困程度分类呈非线性社会梯度，而收入在所有肥胖类别、平均 BMI 和平均 WC 中呈线性社会梯度。收入最低和最高的社会经济群体之间观察到的平均 BMI 和平均 WC 差异具有统计学意义。
所有三种肥胖类型都存在社会梯度，在受教育程度较高、城市地区、高收入和高社会地位的人群中更为普遍。尽管孕产妇和婴儿死亡率等其他公共卫生指标显示出既定的社会梯度，但较高的社会经济群体仍然面临所有类型肥胖的更高风险。
