Centre for the Study of Regional Development, Jawaharlal Nehru University, New Delhi, India.
National Institute of Urban Affairs (NIUA), New Delhi, India.
PLoS One. 2023 Jan 4;18(1):e0279840. doi: 10.1371/journal.pone.0279840. eCollection 2023.
This study assessed the spatial dimension of urban-rural disparity in obesity prevalence and identified the determinants explaining the urban-rural gap in obesity prevalence in India.
Using cross-sectional survey data from the 2015-16 National Family Health Survey, the prevalence rates of obesity were calculated for aged 15-49 years. Two multiscale geographically weighted regressions were performed separately from rural and urban spaces for Indian districts to examine the spatial relationship of the outcome variable and covariates at different geographical scales. Fairlie decomposition analysis was carried out to explore the contribution of each variable in the urban-rural gap.
The rural-urban obesity prevalence difference has increased in a decade time for India from 13.0 to 14.6. Urban counterparts tended to have more people with excess weight. 15 states had an urban-rural prevalence ratio of 2 or higher. The MGWR model showed that varying covariates operated at different scales, i.e. global, regional and local scales, and determined the spatial heterogeneity of obesity prevalence. The only variable, i.e. age (9.49 per cent), had contributed in reducing the gap. Conversely, the socioeconomic variables, i.e. income (96.39 per cent), education (4.95 per cent), caste (4.78 per cent) and occupation (3.11 per cent), had widened the gap.
Even though this study evidenced the rural-urban gap in obesity prevalence, it indicated the gap's closing shortly, as it was witnessed in a few states. It is urgent to address the obesity epidemic, especially in urban India, due to its higher prevalence and prevent the further increase of prevalence in rural India, mainly because it shelters nearly 70 per cent of the Indian population.
本研究评估了肥胖流行的城乡差异的空间维度，并确定了解释印度城乡肥胖流行差距的决定因素。
利用 2015-16 年全国家庭健康调查的横断面调查数据，计算了 15-49 岁人群的肥胖患病率。分别从农村和城市空间对印度各地区进行了两次多尺度地理加权回归，以检验因变量和协变量在不同地理尺度上的空间关系。进行公平分解分析，以探讨每个变量在城乡差距中的贡献。
在十年间，印度农村-城市肥胖流行率差异从 13.0 增加到 14.6。城市地区肥胖的人口比例更高。15 个州的城乡肥胖患病率比为 2 或更高。MGWR 模型表明，不同的协变量在不同的尺度上起作用，即全球、区域和局部尺度，并确定了肥胖患病率的空间异质性。唯一的变量，即年龄（9.49%），有助于缩小差距。相反，社会经济变量，即收入（96.39%）、教育（4.95%）、种姓（4.78%）和职业（3.11%），扩大了差距。
尽管本研究证明了肥胖流行的城乡差距，但它表明差距即将缩小，因为在少数几个州已经看到了这种情况。由于印度城市地区肥胖的流行率较高，因此迫切需要解决肥胖问题，并防止农村地区肥胖流行率的进一步上升，因为农村地区人口占印度总人口的近 70%。
