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Original Articles
Distribution and social determinants of overweight and obesity: a cross-sectional study of non-pregnant adult women from the Malawi Demographic and Health Survey (2015-2016)
Leonard Mndala, Abhay Kudale
Epidemiol Health. 2019;41:e2019039.   Published online September 27, 2019
DOI: https://doi.org/10.4178/epih.e2019039
  • 13,105 View
  • 270 Download
  • 13 Web of Science
  • 13 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Hitherto regarded as a public health issue of well-heeled nations, overweight and obesity have emerged as a problem of concern in developing nations. Although social and demographic factors are equally important as proximal lifestyle factors affecting health, their role is neither well researched nor well understood. We conducted a novel study to determine the distribution, prevalence, and social and demographic determinants of overweight/obesity in Malawi.
METHODS
A population-based, quantitative cross-sectional study using data from the Malawi Demographic and Health Survey (2015-2016) was conducted among non-pregnant women aged 18-49 years. A total of 6,443 women were included in the analysis. Overweight/obesity, defined as a body mass index (BMI) ≥25.0 kg/m2 , was the main outcome variable. The analysis was done in SPSS version 20.0; after calculating descriptive statistics, bivariate and multivariate logistic regression was conducted to evaluate associations and determine odds.
RESULTS
In total, 16.8% and 6.3% of women were overweight and obese, respectively (p<0.001). Overweight and obesity were more prevalent in urban than in rural areas. The BMI distribution among women varied across different background characteristics. Women from the Ngoni ethnicity were more likely to be overweight/obese than others (adjusted odds ratio [aOR], 1.54; 95% confidence interval [CI], 1.14 to 2.08). Socioeconomic status (SES) and the age of the respondent were highly significant determinants that were strongly associated with being overweight/obese. The richest women were 3 times more likely to be overweight/obese than the poorest (aOR, 3.30; 95% CI, 2.46 to 4.43).
CONCLUSIONS
Overweight and obesity were highly prevalent and significantly associated with increasing SES, age, and being from the Ngoni ethnicity. Holistic interventions should also focus on improving social determinants in order to entirely curb the epidemic.
Summary

Citations

Citations to this article as recorded by  
  • Exploring the Causes of Obesity Among Adults in the Kurdish Regions of Iran: A Qualitative Study
    Seyed Fahim Irandoost, Bahman Bayangani, Tahereh Dehdari, Javad Yousefi Lebni, Nafe Babasfari, Nafiul Mehedi, Mohammad Hosein Taghdisi
    Community Health Equity Research & Policy.2023; 43(2): 183.     CrossRef
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    Bertille Daran, Pierre Levasseur, Matthieu Clément
    Obesity Reviews.2023;[Epub]     CrossRef
  • Analysis of Correlation between the Socioeconomic Environment and Level of Nutrition in the Population of Serbia: A Part of the National Survey
    Mladen Grujicic, Marija Sekulic, Milos Stepovic, Natasa Zdravkovic, Vladan Markovic, Jagoda Gavrilovic, Mirjana Veselinovic, Jelena Vuckovic-Filipovic, Katarina Nikolic, Olivera Milovanovic, Branimir Radmanovic, Bojan Milosevic, Rada Vucic, Stefan Jakovlj
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    GeoJournal.2022; 87(5): 3793.     CrossRef
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    International Journal of Environmental Research and Public Health.2022; 19(10): 6171.     CrossRef
  • Maternal overweight and obesity and its associated factors and outcomes in human immunodeficiency virus (HIV)‐infected and HIV‐uninfected black South African pregnant women
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    Journal of Obstetrics and Gynaecology Research.2022; 48(11): 2697.     CrossRef
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    Appetite.2021; 156: 104855.     CrossRef
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Decomposing economic disparities in risky sexual behaviors among people who inject drugs in Tehran: Blinder-Oaxaca decomposition analysis
Mehdi Noroozi, Hamid Sharifi, Alireza Noroozi, Fatemah Rezaei, Mohammad Rafi Bazrafshan, Bahram Armoon
Epidemiol Health. 2017;39:e2017049.   Published online November 5, 2017
DOI: https://doi.org/10.4178/epih.e2017049
  • 11,893 View
  • 241 Download
  • 1 Web of Science
AbstractAbstract PDF
Abstract
OBJECTIVES
To our knowledge, no previous study has systematically assessed the role of economic status in risky sexual behavior among people who inject drugs (PWID) in Iran. In this study, we used Blinder-Oaxaca (BO) decomposition to explore the contribution of economic status to inequality in unprotected sex among PWID in Tehran and to decompose it into its determinants.
METHODS
Behavioral surveys among PWID were conducted in Tehran, the capital city of Iran, from November 2016 to April 2017. We employed a cross-sectional design and snowball sampling methodology. We constructed the asset index (weighted by the first principal component analysis factor) using socioeconomic data and then divided the variable into 3 tertiles. We used the BO method to decompose the economic inequality in unprotected sex.
RESULTS
Of the 520 recruited individuals, 20 were missing data for variables used to define their economic status, and were therefore excluded from the analysis. Not having access to harm reduction programs was the largest factor contributing to the economic disparity in unprotected sex, accounting for 5.5 percentage points of the 21.4% discrepancy. Of the unadjusted total economic disparity in unprotected sex, 52% was unexplained by observable characteristics included in the regression model. The difference in the prevalence of unprotected sex between the high-income and low-income groups was 25%.
CONCLUSIONS
Increasing needle syringe program coverage and improving human immunodeficiency virus (HIV) knowledge are essential for efforts to eliminate inequalities in HIV risk behaviors among PWID.
Summary
Prevalence of factors related to active reproductive health behavior: a cross-sectional study Indonesian adolescent
Tantut Susanto, Iis Rahmawati, Emi Wuri Wuryaningsih, Ruka Saito, Syahrul, Rumiko Kimura, Akiko Tsuda, Noriko Tabuchi, Junko Sugama
Epidemiol Health. 2016;38:e2016041.   Published online September 30, 2016
DOI: https://doi.org/10.4178/epih.e2016041
  • 24,077 View
  • 431 Download
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Complex and diverse factors are related to reproductive health (RH) behavior among adolescents according to the social and cultural context of each countries. This study examined the prevalence of active RH and factors related to active RH behavior among Indonesian adolescents.
METHODS
A cross-sectional study was conducted among 1,040 of students who were selected through a multi-stage random sampling technique. A self-administered questionnaire was developed, including the World Health Organization Illustrative Questionnaire for Interview-Surveys with Young People, pubertal development scale, and sexual activity scale, modified in accordance to the Indonesian context. The data were analyzed using descriptive and comparative statistics, as well as logistic regression analyses.
RESULTS
The prevalence of active RH behavior were more higher in boys (56.6%; 95% confidence interval [CI], 50.6% to 62.6%) than in girls (43.7%; 95% CI, 37.6% to 49.8%). Negative attitudes towards RH were a factor related to active RH behavior in both boys and girls. Smoking and kind relationship envisioned before marriage (pacaran [courtship] and nikah siri [non-registered marriage]) were factors related to active RH behavior in boys; whereas the absence of access to information on substance abuse was an additional factor in girls. Moreover, an interaction was found between access to information on development and smoking (boys) and attitudes on RH (girls) as independent variables associated with active RH behavior.
CONCLUSIONS
Sex education for adolescents in Indonesia, particularly in the context of a health promotion program, should be developed based on prevalent social, cultural, and religious values to prevent active RH behavior. Such programs should focus on the kind of relationship envisioned before marriage and smoking for boys and access to information on subtance abuse for girls.
Summary

Citations

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  • Comparing the effect of LINE-based and WhatsApp-based educational interventions on reproductive health knowledge, attitudes, and behaviors among Triad adolescents: A quasi-experimental study
    Cecep Eli Kosasih, Tetti Solehati, Ida Maryati
    Belitung Nursing Journal.2024; 10(1): 87.     CrossRef
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Associations of smoking with overall obesity, and central obesity: a cross-sectional study from the Korea National Health and Nutrition Examination Survey (2010-2013)
Yeonjung Kim, Seong Min Jeong, Bora Yoo, Bitna Oh, Hee-Cheol Kang
Epidemiol Health. 2016;38:e2016020.   Published online May 19, 2016
DOI: https://doi.org/10.4178/epih.e2016020
  • 17,223 View
  • 280 Download
  • 20 Web of Science
  • 21 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The association between smoking and obesity is a significant public health concern. Both are preventable risk factors of cardiovascular disease and a range of other conditions. However, despite numerous previous studies, no consensus has emerged regarding the effect of smoking on obesity. We therefore carried out a novel study evaluating the relationship between smoking and obesity.
METHODS
A total of 5,254 subjects aged 19 years or older drawn from the 2010-2013 Korea National Health and Nutrition Examination Survey were included in this cross-sectional study. Smoking was examined both in terms of smoking status and the quantity of cigarettes smoked by current smokers. Multiple logistic regression analysis was used to assess the association between smoking and obesity. Overall obesity was defined as a body mass index (BMI) ≥25 kg/m2, and central obesity was defined as a waist circumference ≥90 cm for males and ≥85 cm for females. We adjusted for the possible confounding effects of age, sex, physical activity, alcohol consumption, and the presence of hypertension or diabetes.
RESULTS
A statistically significant difference in central obesity according to smoking status was identified. Current smokers were more likely to be centrally obese than never-smokers (adjusted odds ratio,1.30; 95% confidence interval, 1.02 to 1.67). However, no significant association was found between smoking and obesity defined by BMI. Moreover, among current smokers, no statistically significant association was found between the daily amount of smoking and obesity or central obesity.
CONCLUSIONS
Smoking was positively associated with central obesity. Current smokers should be acquainted that they may be more prone to central obesity.
Summary
Korean summary
이 연구는 국민건강영양조사(2010-2013) 자료를 이용하여 한국 성인에서 흡연과 비만의 연관성을 분석하였다. 현재 흡연자는 비흡연자와 비교하여 비만의 위험도는 유의한 차이를 보이지 않았지만 복부비만의 위험도는 유의하게 증가하였다. 흡연이 복부 비만의 위험증가와 연관성이 있음을 확인하였으며 향후 인과관계 및 기전 규명을 위한 연구가 필요할 것으로 생각된다.

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