Nglazi Mweete D, Ataguba John E
Health Economics Unit, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa.
Department of Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
SSM Popul Health. 2022 Aug 6;19:101170. doi: 10.1016/j.ssmph.2022.101170. eCollection 2022 Sep.
This study assesses socioeconomic inequality in the intergenerational transmission of overweight and obesity from mothers to offsprings in South Africa, including the factors contributing to inequality. Data were drawn from the 2017 National Income Dynamic Study, which collected anthropometric and socioeconomic information. Non-pregnant mothers aged 15-49 years and their offsprings 0-14 years were included in the analysis. The dependent variables used in the study were the intergenerational transmission of overweight and obesity. Socioeconomic inequality was assessed using the concentration index. A positive index means that intergenerational overweight and obesity is more likely among the wealthier populations, while a negative index signifies the opposite. The concentration index was decomposed to understand the factors that explain inequalities in the transmission of overweight and obesity from mothers to offsprings. Concentration indices for the intergenerational transmission of overweight and obesity were positive for boys (0.17) and girls (0.23). Thus the intergenerational transmission of overweight and obesity occurs more among wealthier mothers. Although factors explaining socioeconomic inequality in the intergenerational transmission of overweight and obesity differed by offspring sex, mother's marital status (+38%) and socioeconomic status (around +8%) were central determinants of socioeconomic inequalities in intergenerational overweight, while mother's smoking (around +25%), education (about +13%) and employment status (around +12%) contributed to intergenerational obesity inequality. Policies to reduce overweight and obesity burdens and the intergenerational transmission of overweight and obesity in South Africa should target women who bear a significant burden of overweight and obesity and could transmit them to their offsprings. The policies should also recognise the key factors explaining these socioeconomic inequalities. This approach will reduce the future burden of diseases associated with overweight and obesity in South Africa and improve the country's overall health outcomes.
本研究评估了南非超重和肥胖从母亲到子女的代际传递中的社会经济不平等现象，包括导致不平等的因素。数据取自2017年全国收入动态研究，该研究收集了人体测量和社会经济信息。分析纳入了年龄在15至49岁的未怀孕母亲及其0至14岁的子女。本研究中使用的因变量是超重和肥胖的代际传递。使用集中指数评估社会经济不平等。正指数意味着代际超重和肥胖在较富裕人群中更有可能出现，而负指数则表示相反情况。对集中指数进行分解，以了解解释超重和肥胖从母亲到子女传递过程中不平等现象的因素。超重和肥胖代际传递的集中指数，男孩为正（0.17），女孩为正（0.23）。因此，超重和肥胖的代际传递在较富裕的母亲中更为常见。尽管解释超重和肥胖代际传递中社会经济不平等的因素因子女性别而异，但母亲的婚姻状况（+38%）和社会经济地位（约+8%）是代际超重社会经济不平等的核心决定因素，而母亲的吸烟情况（约+25%）教育程度（约+13%）和就业状况（约+12%）导致了代际肥胖不平等。南非减轻超重和肥胖负担以及超重和肥胖代际传递的政策应针对承担超重和肥胖重大负担且可能将其传递给子女的女性。这些政策还应认识到解释这些社会经济不平等现象的关键因素。这种方法将减轻南非未来与超重和肥胖相关的疾病负担，并改善该国的整体健康状况。
