Department of Population Health, London School of Hygiene and Tropical Medicine, Room G81, LSHTM, Keppel St, Bloomsbury, London, WC1E 7HT, UK.
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
BMC Public Health. 2019 Jun 20;19(1):783. doi: 10.1186/s12889-019-7155-9.
BACKGROUND: India's economic development and urbanisation in recent decades has varied considerably between states. Attempts to assess how overweight (including obesity) varies by socioeconomic position at the national level may mask considerable sub-national heterogeneity. We examined the socioeconomic patterning of overweight among adults in India's most and least economically developed states between 1998 and 2016. METHODS: We used state representative data from the National Family Health Surveys from 1998 to 99, 2005-06 and 2015-16. We estimated the prevalence of overweight by socioeconomic position in men (15-54 years) and women (15-49 years) from India's most and least economically developed states using multilevel logistic regressions. RESULTS: We observed an increasing trend of overweight prevalence among low socioeconomic position women. Amongst high socioeconomic position women, overweight prevalence either increased to a smaller extent, remained the same or even declined between 1998 and 2016. This was particularly the case in urban areas of the most developed states, where in the main analysis, the prevalence of overweight increased from 19 to 33% among women from the lowest socioeconomic group between 1998 and 2016 compared to no change among women from the highest socioeconomic group. Between 2005 and 2016, the prevalence of overweight increased to similar extents among high and low socioeconomic status men, irrespective of residence. CONCLUSIONS: The converging prevalence of overweight by socioeconomic position in India's most developed states, particularly amongst urban women, implies that this subpopulation may be the first to exhibit a negative association between socioeconomic position and overweight in India. Programs aiming to reduce the increasing overweight trends may wish to focus on poorer women in India's most developed states, amongst whom the increasing trend in prevalence has been considerable.
背景:近几十年来,印度的经济发展和城市化进程在各州之间存在着显著差异。在国家层面上评估超重(包括肥胖)的社会经济地位差异,可能会掩盖相当大的次国家差异。我们研究了印度最发达和最不发达的两个州在 1998 年至 2016 年间成年人超重的社会经济分布情况。
方法:我们使用了来自国家家庭健康调查的州代表性数据,这些数据来自 1998 年至 99 年、2005 年至 06 年和 2015 年至 16 年。我们使用多层逻辑回归估计了印度最发达和最不发达两个州的男性(15-54 岁)和女性(15-49 岁)中不同社会经济地位的超重患病率。
结果:我们观察到低社会经济地位女性的超重患病率呈上升趋势。而在高社会经济地位女性中,超重患病率的增加幅度要么较小,要么保持不变,甚至在 1998 年至 2016 年间有所下降。在最发达各州的城市地区尤其如此,在主要分析中,1998 年至 2016 年间,最低社会经济组别的女性超重患病率从 19%上升到 33%,而最高社会经济组别的女性则没有变化。在 2005 年至 2016 年期间,无论居住地如何,高社会经济地位和低社会经济地位男性的超重患病率都以相似的幅度增加。
结论:印度最发达各州的超重患病率按社会经济地位趋同,特别是在城市女性中,这意味着这部分人群可能是印度第一个表现出超重与社会经济地位之间负相关关系的人群。旨在减少超重趋势的项目可能希望将重点放在印度最发达各州的贫困妇女身上,她们的超重患病率增长趋势相当可观。
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