Goryakin Yevgeniy, Rocco Lorenzo, Suhrcke Marc
The Organisation for Economic Co-operation and Development, Paris, France.
Department of Economics and Management, University of Padova, Padova, Italy.
Econ Hum Biol. 2017 Aug;26:151-163. doi: 10.1016/j.ehb.2017.03.004. Epub 2017 Mar 27.
It is widely believed that the expanding burden of non-communicable diseases (NCDs) is in no small part the result of major macro-level determinants. We use a large amount of new data, to explore in particular the role played by urbanization - the process of the population shifting from rural to urban areas within countries - in affecting four important drivers of NCDs world-wide: diabetes prevalence, as well as average body mass index (BMI), total cholesterol level and systolic blood pressure. Urbanization is seen by many as a double-edged sword: while its beneficial economic effects are widely acknowledged, it is commonly alleged to produce adverse side effects for NCD-related health outcomes. In this paper we submit this hypothesis to extensive empirical scrutiny, covering a global set of countries from 1980-2008, and applying a range of estimation procedures. Our results indicate that urbanization appears to have contributed to an increase in average BMI and cholesterol levels: the implied difference in average total cholesterol between the most and the least urbanized countries is 0.40mmol/L, while people living in the least urbanized countries are also expected to have an up to 2.3kg/m lower BMI than in the most urbanized ones. Moreover, the least urbanized countries are expected to have an up to 3.2p.p. lower prevalence of diabetes among women. This association is also much stronger in the low and middle-income countries, and is likely to be mediated by energy intake-related variables, such as calorie and fat supply per capita.
人们普遍认为，非传染性疾病（NCDs）负担不断加重，在很大程度上是由主要的宏观层面决定因素造成的。我们使用大量新数据，特别探讨城市化——即一个国家内人口从农村向城市地区转移的过程——在影响全球非传染性疾病的四个重要驱动因素方面所起的作用：糖尿病患病率，以及平均体重指数（BMI）、总胆固醇水平和收缩压。许多人认为城市化是一把双刃剑：虽然其有益的经济影响得到广泛认可，但人们普遍认为它会对与非传染性疾病相关的健康结果产生不良副作用。在本文中，我们对这一假设进行了广泛的实证检验，涵盖了1980年至2008年全球范围内的一组国家，并应用了一系列估计程序。我们的结果表明，城市化似乎导致了平均BMI和胆固醇水平的上升：城市化程度最高和最低的国家之间平均总胆固醇的隐含差异为0.40mmol/L，而生活在城市化程度最低国家的人的BMI预计比城市化程度最高国家的人低2.3kg/m。此外，城市化程度最低的国家预计女性糖尿病患病率低3.2个百分点。这种关联在低收入和中等收入国家也更强，并且可能由与能量摄入相关的变量介导，例如人均卡路里和脂肪供应。
