Hasan Md Mehedi
Department of Business Administration, North Western University, Khulna, Bangladesh.
Nutr Health. 2025 Mar;31(1):155-163. doi: 10.1177/02601060231163365. Epub 2023 Mar 20.
Due to rapid socioeconomic development and epidemiological transition, socioeconomic inequality of underweight, overweight, and obesity are becoming a public health concern in Bangladesh. There is a need for country-specific evidence of nutrition inequalities in Bangladesh. The aim of the study was to measure socioeconomic inequality and decomposition analysis along with the sex differences in underweight, overweight, and obesity among the adult population. A secondary data analysis was performed in the Bangladesh Demographic and Health Survey (BDHS) 2017-18, a cross-sectional survey used a multi-stage cluster sampling technique. Sociodemographic variables including age, sex, education, socioeconomic status, marital status, and anthropometric data of height and weight were considered for analysis. Body mass index was used for defining underweight, overweight, and obesity. Concentration index (CI) and decomposition analysis were performed for underweight, overweight, and obesity. The proportion of underweight was 15.0%, overweight (23.0%), and obese (5.0%). Underweight was higher in males, whereas overweight and obesity were higher in females. The CI of underweight was -0.121 ( < 0.001), indicating socioeconomic inequality concentrated on lowering socioeconomic status; living in rural areas contributed 14.2% to this inequality. The CI of overweight and obesity was 0.213 ( < 0.001) and 0.142 ( < 0.001), respectively, indicating that inequalities of overweight and obesity concentrated in higher socioeconomic status; urban residency contributed 14.1% and 18.0% to socioeconomic inequality of overweight and obesity. Underweight remains a significant problem for poor people in rural areas, but overweight and obesity were highly prevalent in the higher socioeconomic status of urban areas. Education level and young age group significantly contribute to the socioeconomic inequality of malnutrition. A more detailed epidemiological study is required to understand the causes of socioeconomic disparities of nutritional status in Bangladesh.
由于社会经济的快速发展和流行病学转变，体重不足、超重和肥胖的社会经济不平等现象在孟加拉国正成为一个公共卫生问题。孟加拉国需要有针对该国的营养不平等证据。本研究的目的是测量成年人群中体重不足、超重和肥胖的社会经济不平等及分解分析，并探讨性别差异。对2017 - 18年孟加拉国人口与健康调查（BDHS）进行了二次数据分析，该横断面调查采用了多阶段整群抽样技术。分析时考虑了社会人口学变量，包括年龄、性别、教育程度、社会经济地位、婚姻状况以及身高和体重的人体测量数据。采用体重指数来定义体重不足、超重和肥胖。对体重不足、超重和肥胖进行了集中指数（CI）和分解分析。体重不足的比例为15.0%，超重为23.0%，肥胖为5.0%。男性体重不足的比例较高，而女性超重和肥胖的比例较高。体重不足的CI为 - 0.121（P < 0.001），表明社会经济不平等集中在社会经济地位较低者；农村地区对这种不平等的贡献率为14.2%。超重和肥胖的CI分别为0.213（P < 0.001）和0.142（P < 0.001），表明超重和肥胖的不平等集中在社会经济地位较高者；城市居住对超重和肥胖的社会经济不平等贡献率分别为14.1%和18.0%。体重不足仍然是农村贫困人口的一个重大问题，但超重和肥胖在城市地区较高社会经济地位人群中非常普遍。教育水平和年轻年龄组对营养不良的社会经济不平等有显著影响。需要进行更详细的流行病学研究，以了解孟加拉国营养状况社会经济差异的原因。
