Geographic and Socioeconomic Disparities in Nutritional Status of Women in Pakistan: Secondary Analysis from Pakistan National Nutrition Survey

Abstract Background: Pakistan is experiencing a rapid nutrition transition with a shift from underweight to overweight and obesity. This paper will examine the role of household socioeconomic position (SEP), community SEP and urbanicity on the nutritional status (underweight, overweight and obesity) of Pakistani women. Methods: We analysed data on 34,391 women aged ≥20 years enrolled in 2011 National Nutritional Survey of Pakistan (NNS). The NNS is a nationally representative survey employing a multistage stratified cluster sampling design. We assessed household SEP through a wealth index constructed using items from household possessions, utilities and housing conditions. We assessed the relationship of urbanicity, household and community SEP with categories of body mass index (BMI) using multinomial logistic regression where normal BMI (18.6-22.5 kg/m 2 ) was the reference category. Results: Overall, 15% of women were underweight (BMI<18.5 kg/m 2 ), 14% were pre-overweight (BMI 23.00-24.9 kg/m 2 ), 22% were overweight (BMI 25.0-29.99 kg/m 2 ) and 12% were obese (BMI≥30.0 kg/m 2 ). Households with higher SEP were associated with increased levels of overweight-1 (aOR: 2.91; 95%CI: 2.41-3.50), overweight-2 (aOR: 4.15; 95%CI: 3.31-5.19) and obesity (aOR: 6.20; 95%CI: 4.92-7.81) among women. Women were more likely to be obese in major urban (aOR: 2.34; 95%CI: 2.02-2.71) and urban (aOR: 1.84; 95%CI: 1.62-2.09) areas compared to rural areas. At the community level, communities in rural areas were more likely to have higher levels of underweight, while communities in urban areas were more likely to have higher levels of obesity. Furthermore, the likelihood of underweight and overweight women coexisting within the same community was low in major urban (r=0.67), urban (r=0.55) and rural (r=0.54) areas. Conclusions: In Pakistan, overweight and obesity among women is associated with urbanicity and household and community SEP. Women living in urban areas with high household and community SEP were associated with higher levels of overweight and obesity. Our findings suggest the importance of interventions targeting undernutrition in rural areas and overnutrition in urban areas.

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Urban-Rural Differences in Nutritional Status and Dietary Intakes of School-Aged Children in Cambodia

Nutrients ◽

10.3390/nu11010014 ◽

2018 ◽

Vol 11 (1) ◽

pp. 14 ◽

Cited By ~ 5

Author(s):

Yoko Horiuchi ◽

Kaoru Kusama ◽

Sar Kanha ◽

Nobuo Yoshiike ◽

Keyword(s):

Nutritional Status ◽

Rural Areas ◽

Urban Areas ◽

Age Groups ◽

Overweight And Obesity ◽

Dietary Intakes ◽

Nutrition Survey ◽

Rural And Urban Areas ◽

School Aged Children ◽

Urban Rural

: This study aimed to describe the nutritional status and dietary patterns of Cambodian school-aged children compared with those in the South East Asian Nutrition Survey (SEANUTS; Indonesia, Malaysia, Thailand, and Vietnam in 2011) and to clarify the urban-rural differences using data from a nationally representative sample. The survey was conducted in 2014/2015 with a sample of 2020 children aged 6–17 years from 136 randomly selected schools. Standardized anthropometric measurements and a 1-day dietary survey by 24-hour recall method were conducted. Extended analyses in the present study revealed that the difference between rural and urban areas was similar to that of the SEANUTS; the overall prevalence of stunting remained high (33.2%). Stunting was more prevalent in children living in rural areas than in those in urban areas (total: 36.4% vs 20.4%). In contrast, the overall prevalence of overweight and obesity was not as high (3.1%), but was higher among urban children in all age groups compared with those living in rural areas (total: 6.4% vs 2.3%). Overall, the dietary intake of children did not meet the local recommended dietary allowances, which was similar to the results of the SEANUTS and differed across urban and rural areas.

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Nutritional status of Tunisian adolescents: associated gender, environmental and socio-economic factors

Public Health Nutrition ◽

10.1017/s1368980008002693 ◽

2008 ◽

Vol 11 (12) ◽

pp. 1306-1317 ◽

Cited By ~ 44

Author(s):

Hajer Aounallah-Skhiri ◽

Habiba Ben Romdhane ◽

Pierre Traissac ◽

Sabrina Eymard-Duvernay ◽

Francis Delpeuch ◽

...

Keyword(s):

Nutritional Status ◽

Abdominal Obesity ◽

Rural Areas ◽

Urban Areas ◽

Eating Habits ◽

Public Health Problem ◽

Cross Sectional Study ◽

Overweight And Obesity ◽

Cultural Tradition ◽

Cross Sectional

AbstractObjectiveTo assess the nutritional status of Tunisian adolescents and associated factors.DesignA cross-sectional study based on a national stratified random cluster sample.Subjects and methodsIn all, 1295 boys and 1577 girls aged 15–19 years, of whom 28·4 % had already left school. Socio-economic characteristics of the parents, anthropometric measurements, food behaviours and physical activity of the adolescents were recorded during home visits.ResultsPrevalence of underweight, overweight and obesity (WHO/National Center for Health Statistics reference) were, respectively, 8·1 %, 17·4 % and 4·1 % among boys and 1·3 %, 20·7 % and 4·4 % among girls; abdominal obesity was highly prevalent among both sexes. Prevalence of overweight differed by region (from 11·5 % to 22·2 %) and was higher in urban v. rural areas for males (21·7 % v. 10·4 %) but not for females (21·7 % v. 19·2 %). These differences were partially mediated by socio-economic and lifestyle factors for males. For females, influence of cultural factors is hypothesised. In rural areas, overweight was more prevalent among boys of higher economic level households, having a working mother or a sedentary lifestyle; for girls, prevalence increased with the level of education of the mother. In urban areas, prevalence of overweight was related to eating habits: it was higher for boys with irregular snacking habits and for girls skipping daily meals. Urban girls having left school were also more overweight.ConclusionOverweight and abdominal obesity in late adolescence have become a true public health problem in Tunisia with the combined effects of cultural tradition for girls in rural areas, and of rapid economic development for boys and girls in cities.

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Disparities in the Nutritional Status of Children (0–23 Months) in Kenya

Current Developments in Nutrition ◽

10.1093/cdn/nzaa053_072 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 867-867

Author(s):

Teresia Mbogori

Keyword(s):

Nutritional Status ◽

Rural Areas ◽

Urban Areas ◽

Social Economic ◽

Economic Status ◽

Wealth Index ◽

Childhood Malnutrition ◽

Social Economic Status ◽

Z Scores ◽

Nutritional Status Of Children

Abstract Objectives To determine the social economic and rural/urban disparities in the nutritional status of children aged 0–23 months in Kenya. Methods This study utilized data from the most current Kenya Demographic and Health Survey (KDHS), a nationally representative cross-sectional study conducted in 2014. Data from children 0–23 months with complete information on weight, height, age and sex were used for analysis. Height for Age Z scores (HAZ), Weight for Age Z scores (WAZ), Weight for Height Z scores (WHZ), and BMI for Age Z scores (BAZ) were computed using WHO Anthroplus program to determine the nutritional status of the children. Chi square statistics were used to determine the relationship between wealth index, education status of mother, rural/urban residence, gender, and the nutritional status of the children. Significance was set at P < 0.05. Results Among all participating children aged 0–23 months (n = 7578), 22.7% were stunted (HAZ < −2), 10.7% were underweight (WAZ < −2), 6.2% were wasted (WHZ < −2), and 6.1% were either overweight or obese (BAZ > 2). Wasting, stunting, and underweight were significantly higher in children from rural areas, poorer wealth index and from mothers with no education. In contrast, children from urban areas, from richest wealth index category and from mothers with secondary or higher education were significantly more likely to be either overweight or obese. There were no gender differences in all the indicators of malnutrition. Stunting, wasting and underweight were also significantly higher in older children (6–23 months) as compared to the younger children (0–5 months). Conclusions Disparities exist in childhood malnutrition in Kenya with children from low social economic status and those living in rural areas experiencing higher rates of under-nutrition whereas those living in urban areas and those from higher social economic status experiencing higher rates of overweight and obesity. Current and new policies need to address these disparities to ensure that childhood malnutrition continues to improve in all sectors of the society. Funding Sources No funding source.

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Socio-economic inequalities in the association between alcohol use disorder and depressive disorder among Thai adults: a population-based study

BMC Psychiatry ◽

10.1186/s12888-020-02958-6 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Sawitri Assanangkornchai ◽

Jiraluck Nontarak ◽

Wichai Aekplakorn ◽

Suwat Chariyalertsak ◽

Pattapong Kessomboon ◽

...

Keyword(s):

Alcohol Use ◽

Depressive Disorder ◽

Rural Areas ◽

Urban Areas ◽

Alcohol Use Disorder ◽

Multinomial Logistic Regression ◽

Wealth Index ◽

Outcome Variable ◽

Health Examination ◽

Major Depressive

Abstract Background Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups. Methods We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged > 20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0–7), hazardous drinking (score 8–15), and harmful-dependent drinking (score 16–40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels. Results The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5, 10.3, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR = 8.68, 95% CI: 5.34, 14.11) and lowest (AOR = 7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR = 1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR = 16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR = 1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR = 8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR = 4.73, 95% CI: 3.31, 6.77). Conclusion Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.

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Are parental dietary patterns associated with children’s overweight and obesity in China?

BMC Pediatrics ◽

10.1186/s12887-020-1910-z ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Daisheng Tang ◽

Tao Bu ◽

Xuefan Dong

Keyword(s):

Food Intake ◽

Dietary Patterns ◽

Rural Areas ◽

Urban Areas ◽

Regional Differences ◽

Developmental Stages ◽

Great Influence ◽

Overweight And Obesity ◽

Nutrition Survey ◽

Cross Sectional

Abstract Background It is believed that parents have a great influence on their children’s dietary behaviours. However, it is not clear whether parental food patterns are associated with children’s nutritional status in China, which includes a vast territory with rich, diverse cultures. The goal of this project is to systematically study the associations between parental food intake and children’s overweight and obesity in China, according to children’s ages and regional differences. Methods Based on individual food consumption data from the China Health and Nutrition Survey (CHNS) package in 2011, cross-sectional studies have previously been conducted to analyse the association between different categories of food intake of parents and children. The current study extends this research by directly. Results Our analysis results show that parental food intake is highly correlated with children’s food intake, with the estimated coefficients of most food intake categories being greater than 0.5. Furthermore, this association between parental food intake and children’s overweight and obesity is most significant in young children, but it begins to weaken in relation to children aged between 13 and 18. Additionally, the associations between parental food intake and children’s overnutrition are more significant in rural areas than they are in urban areas. Conclusions The association between parental food intake and childhood overweight and obesity is significant, although it varies considerably according to food categories, children’s ages and area differences. These results show promise for intervening in the overnutrition of children by controlling household dietary patterns according to children’s developmental stages and regional differences.

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Does living in an urban environment confer advantages for childhood nutritional status? Analysis of disparities in nutritional status by wealth and residence in Angola, Central African Republic and Senegal

Public Health Nutrition ◽

10.1079/phn2005835 ◽

2006 ◽

Vol 9 (2) ◽

pp. 187-193 ◽

Cited By ~ 24

Author(s):

Gina Kennedy ◽

Guy Nantel ◽

Inge D Brouwer ◽

Frans J Kok

Keyword(s):

Nutritional Status ◽

Urban Environment ◽

Rural Areas ◽

Urban Areas ◽

Central African Republic ◽

Wealth Index ◽

Living Conditions ◽

Urban Rural ◽

Urban And Rural Areas ◽

Poor Children

AbstractObjectiveThe purpose of this paper is to examine the relationship between childhood undernutrition and poverty in urban and rural areas.DesignAnthropometric and socio-economic data from Multiple Indicator Cluster Surveys in Angola-Secured Territory (Angola ST), Central African Republic and Senegal were used in this analysis. The population considered in this study is children 0–59 months, whose records include complete anthropometric data on height, weight, age, gender, socio-economic level and urban or rural area of residence. In addition to simple urban/rural comparisons, the population was stratified using a wealth index based on living conditions and asset ownership to compare the prevalence, mean Z-score and odds ratios for stunting and wasting.ResultsIn all cases, when using a simple urban/rural comparison, the prevalence of stunting was significantly higher in rural areas. However, when the urban and rural populations were stratified using a measure of wealth, the differences in prevalence of stunting and underweight in urban and rural areas of Angola ST, Central African Republic and Senegal disappeared. Poor children in these urban areas were just as likely to be stunted or underweight as poor children living in rural areas. The odds ratio of stunting in the poorest compared with the richest quintile was 3.4, 3.2 and 1.5 in Angola ST, Senegal and Central African Republic, respectively.ConclusionsThis paper demonstrates that simple urban/rural comparisons mask wide disparities in subgroups according to wealth. There is a strong relationship between poverty and chronic undernutrition in both urban and rural areas; this relationship does not change simply by living in an urban environment. However, urban and rural living conditions and lifestyles differ, and it is important to consider these differences when designing programmes and policies to address undernutrition.

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Socio-economic inequalities in the association between alcohol-use disorder and depressive disorder among Thai adults: a population-based study

10.21203/rs.3.rs-15847/v3 ◽

2020 ◽

Author(s):

Sawitri Assanangkornchai ◽

Jiraluck Nontarak ◽

Wichai Aekplakorn ◽

Suwat Chariyalertsak ◽

Pattapong Kessomboon ◽

...

Keyword(s):

Alcohol Use ◽

Depressive Disorder ◽

Rural Areas ◽

Urban Areas ◽

Alcohol Use Disorder ◽

Multinomial Logistic Regression ◽

Wealth Index ◽

Outcome Variable ◽

Health Examination ◽

Major Depressive

Abstract Background: Previous evidence indicates significant associations between depressive disorders and alcohol use disorder (AUD) and their strong links with social conditions. This study aims to investigate the association between major depressive episode (MDE) and AUD across various socio-economic groups.Methods: We analysed data from the 2014 Thai National Health Examination Survey containing a random sample of 13,177 adults aged >20 years from the general population. The Alcohol Use Disorder Identification Test was used to classify respondents into non-problem drinking (score 0-7), hazardous drinking (score 8-15), and harmful-dependent drinking (score 16-40). MDE was identified using questions based on the DSM-IV. Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were calculated using multinomial logistic regression to determine the strength of associations between MDE as a predictor and AUD as an outcome variable across different socio-economic levels.Results: The prevalence of MDE, hazardous, and harmful-dependent drinking was 2.5%, 10.3%, and 1.9%, respectively. The association between MDE and AUD was modified by wealth index, education level and area of residence. AORs for the association between MDE and harmful-dependent drinking were high among those in the highest (AOR=8.68, 95% CI: 5.34, 14.11) and lowest (AOR=7.14, 95% CI: 3.71, 13.73) levels of wealth index but not significant among those in the middle level (AOR=1.78, 95% CI: 0.74, 4.25). Education had the strongest effect on the relationship between MDE and harmful-dependent drinking (AOR=16.0, 95% CI: 10.30, 24.90 among those completing secondary school or higher and AOR=1.44, 95% CI: 0.63, 3.33 among those completing primary school only). The association between MDE and harmful-dependent drinking was higher among people who lived in urban areas (AOR=8.50, 95% CI: 5.50, 13.13) compared to those living in rural areas (AOR=4.73, 95% CI: 3.31, 6.77).Conclusion: Socio-economic factors modify the association between alcohol use disorder and major depressive disorder among Thai people.

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Demographic and Social-Economic Determinants of Malnutrition among Children (0-23 Months Old) in Kenya

International Journal of Child Health and Nutrition ◽

10.6000/1929-4247.2021.10.03.1 ◽

2021 ◽

Vol 10 (3) ◽

pp. 80-87

Author(s):

Teresia Mbogori ◽

◽

James Muriuki

Keyword(s):

Nutritional Status ◽

Rural Areas ◽

Urban Areas ◽

Social Economic ◽

Economic Status ◽

Wealth Index ◽

Cross Sectional ◽

Economic Determinants ◽

Social Economic Status ◽

Z Scores

Objective: To identify the demographic, social, and economic determinants of malnutrition in Kenya's children aged 0-23 months. Methods: Data from the Kenya Demographic and Health Survey (KDHS), a nationally representative cross-sectional study conducted in 2014/2015, were used in this study. Data from children 0-23 months old with complete information on weight, height, age, and sex were used for analysis. Height for Age Z scores (HAZ), Weight for Height Z scores (WHZ), and BMI for age Z scores (BAZ) was determined using WHO guidelines to determine the nutritional status of the children. Chi-square statistics were used to determine the relationship between social-economic status and place of residence indicators and the nutritional status of the children. Significance was set at p <0.05. Results: Among all participating (n=7578), 22.7% were stunted (HAZ < -2), 6.2% were wasted (WHZ < -2), and 6.1% were either overweight or obese (BAZ > 2). Wasting and stunting were significantly higher in children from rural areas, poorer wealth index, and mothers with no education. In contrast, children from urban areas, the richest wealth index category, and mothers with secondary or higher education were significantly more likely to be overweight or obese. Conclusion: Current and future policies and programs to curb malnutrition in Kenya need to target specific needs of children based on their social-economic status, area of residence, and other demographic characteristics that were identified as determinants of child malnutrition instead of using a general approach.

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Cultural, social and demographic determinants of seeking family planning knowledge, and practice among a Sudanese community

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20183053 ◽

2018 ◽

Vol 5 (8) ◽

pp. 3248

Author(s):

Samia S. Abdulmageed ◽

Mustafa Khidir Elnimeri

Keyword(s):

Family Planning ◽

Rural Areas ◽

Urban Areas ◽

Multinomial Logistic Regression ◽

Reproductive Age ◽

Cluster Sampling ◽

Health Seeking ◽

Cross Sectional ◽

Modern Contraceptives ◽

Contraception Use

Background: About 214 million women in the reproductive age in the developing countries who need to prevent and plan for their pregnancy are not using methods of modern contraceptives. The aim of this study was to investigate the socio-demographic and cultural elements that inform the health-seeking behavior towards family planning among Sudanese women in Sharq-Alneel locality in the Sudan-Africa. Furthermore, the study aimed to identify individuals within Sudanese families, who predominantly interfered with the decision of the women in using of contraceptives for family planning.Methods: A cross-sectional community based study was conducted in September-2017 to February-2018 using structured questionnaire to 576 Sudanese women age of 15-49 years from 4 administrative units. A multistage cluster sampling technique was adopted. Binary and multinomial logistic regression models were used to analyze the results using SPSS version 22.Results: Women respondents were (57.1%), and (42.9%) from rural and urban areas respectively. Women (89.3%) of respondents were married for more than five years. A 381 (66%) women respondents were not using contraception at the time of the study. Women in rural areas were 0.9 less likely to obtain information from other sources than from PHC. There was significant association (p<0.001) between women’s educational level and awareness about contraception.Conclusions: Women use of contraception in Sharq-Alneel was low. Barrier to contraception use for majority of women was that they believe their healths are at risk for using modern contraceptives. There was also high prevalence of respondents’ husbands refused the use of contraceptives.

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