Understanding the obesity dynamics by socioeconomic status in Colombian and Mexican cities using a system dynamics model.

PURPOSE

This paper aims to enrich understanding of the obesity transition among socioeconomic status (SES) strata by gender and age in cities of Colombia and Mexico. The study uses harmonized data from the Salud Urbana en América Latina (SALURBAL) study.

METHODS

A population-level system dynamics model was developed using 2010 and 2015 data from Colombia and 2012 and 2016 data from Mexico (national health surveys). The model simulates the prevalence of different BMI categories (i.e., not overweight, overweight, obese) stratified by gender, age, and SES, in the SALURBAL cities (aggregated to the country level) of Colombia and Mexico from 2010 to 2050. Sample sizes for Colombia in 2010 and Mexico in 2012 were 7420 and 5785 children (<5 years), 21601 and 14413 children and adolescents (5-17 years), and 46597 and 20464 adults (18-64 years), respectively. Sample sizes for Colombia in 2015 and Mexico in 2016 were 4450 and 907 children, 12468 and 2350 children and adolescents, and 90430 and 3413 adults, respectively.

RESULTS

For men in Colombia and Mexico, the burden of obesity is projected to increase among lower SES adults over time. Colombian women show similar patterns observed in men but the burden of obesity was already greater in the lower SES groups as early as 2012. In Mexican women, the burden of obesity in 2012 is higher in the lower SES population; however, the prevalence of obesity is projected to increase at a faster rate in the higher SES population. Patterns for children aged 0-14 years differed by gender and country.

CONCLUSIONS

The model suggests that the prevalence of obesity among SES strata by age and gender in SALURBAL cities of Colombia and Mexico are likely to change over time, and predicts their possible evolution through the different stages of the obesity transition.