scholarly journals "Obesity in the City" – urbanization, health risks and rising obesity rates from the viewpoint of human biology and public health

2021 ◽  
Vol 2 ◽  
Author(s):  
Sylvia Kirchengast ◽  
Dominik Hagmann

In 2007, for the first time worldwide, more people lived in urban conurbations than in rural settlement structures. This advancing urbanization has dramatically altered the living situation, the use of space, as well as human behavior along with the health situation and disease burden. This process began in Europe as early as the 19th century, while developing and emerging countries in particular are currently exposed to increasing urbanization. The burden of disease is clearly altered by living in a confined space, by environmental pollution in urban areas, the impossibility of producing food oneself, and being lost in an anonymous crowd. While city air made people “free” in medieval times, it often makes them “sick” today. Obesogenic environments represent a special problem in urban areas. A lack of physical activity, adverse dietary habits, and stressful and unsafe neighborhoods increase the risk of becoming overweight and obese in urban centers. Recently, modernization in rural areas and an adaptation to urban habits there increase the obesity rates in rural areas in high-income as well as low- and middle-income countries, too. Within cities, marked spatial differences in the prevalence of overweight and obesity occur. In Vienna, Austria, overweight and obesity rates during childhood and adolescence differ markedly between the individual Viennese districts. Highest overweight and obesity rates occur in districts characterized by a low socioeconomic status. 

2008 ◽  
Vol 11 (12) ◽  
pp. 1306-1317 ◽  
Author(s):  
Hajer Aounallah-Skhiri ◽  
Habiba Ben Romdhane ◽  
Pierre Traissac ◽  
Sabrina Eymard-Duvernay ◽  
Francis Delpeuch ◽  
...  

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.


2020 ◽  
Vol 35 (8) ◽  
pp. 1110-1129
Author(s):  
Atsede Aregay ◽  
Margaret O’Connor ◽  
Jill Stow ◽  
Nicola Ayers ◽  
Susan Lee

Abstract Globally, 40 million people need palliative care; about 69% are people over 60 years of age. The highest proportion (78%) of adults are from low- and middle-income countries (LMICs), where palliative care still developing and is primarily limited to urban areas. This integrative review describes strategies used by LMICs to establish palliative care in rural areas. A rigorous integrative review methodology was utilized using four electronic databases (Ovid MEDLINE, Ovid Emcare, Embase classic+Embase and CINAHL). The search terms were: ‘palliative care’, ‘hospice care’, ‘end of life care’, ‘home-based care’, ‘volunteer’, ‘rural’, ‘regional’, ‘remote’ and ‘developing countries’ identified by the United Nations (UN) as ‘Africa’, ‘Sub-Saharan Africa’, ‘low-income’ and ‘middle- income countries’. Thirty papers published in English from 1990 to 2019 were included. Papers were appraised for quality and extracted data subjected to analysis using a public health model (policy, drug availability, education and implementation) as a framework to describe strategies for establishing palliative care in rural areas. The methodological quality of the reviewed papers was low, with 7 of the 30 being simple programme descriptions. Despite the inclusion of palliative care in national health policy in some countries, implementation in the community was often reliant on advocacy and financial support from non-government organizations. Networking to coordinate care and medication availability near-patient homes were essential features of implementation. Training, role play, education and mentorship were strategies used to support health providers and volunteers. Home- and community-based palliative care services for rural LMICs communities may best be delivered using a networked service among health professionals, community volunteers, religious leaders and technology.


2019 ◽  
pp. 1-7
Author(s):  
Saad Alshahrani ◽  
Ahmed Hablas ◽  
Robert M. Chamberlain ◽  
Jane Meza ◽  
Steven Remmenga ◽  
...  

PURPOSE Uterine cancer is a top-ranking women’s cancer worldwide, with wide incidence variations across countries and by rural and urban areas. Hormonal exposures and access to health care vary between rural and urban areas, globally. Egypt has an overall low incidence of uterine cancer but variable rural and urban lifestyles. Are there changes in the incidence of uterine cancer in rural and urban areas in middle-income countries such as Egypt? No previous studies have addressed this question from a well-characterized and validated population-based cancer registry resource in middle-income countries. The aim of this study was to explore the differences in clinical and demographic characteristics of uterine cancer over the period of 1999 to 2010 in rural and urban Gharbiah province, Egypt. METHODS Data were abstracted for all 660 patients with uterine cancer included in the Gharbiah Population-based Cancer Registry. Clinical variables included tumor location, histopathologic diagnosis, stage, grade, and treatment. Demographic variables included age, rural or urban residence, parity, and occupation. Crude and age-adjusted incidence rates (IRs) and rate ratios by rural or urban residence were calculated. RESULTS No significant differences were observed in most clinical and demographic characteristics between rural and urban patients. The age standardized IR (ASR) was 2.5 times higher in urban than in rural areas (6.9 and 2.8 per 100,000 in urban and rural areas, respectively). The rate ratio showed that the IR in urban areas was 2.46 times the rate in rural areas. CONCLUSION This study showed that the disease IR in rural areas has increased in the past decade but is still low compared with the incidence in urban areas in Egypt, which did not show a significant increase in incidence. Nutritional transitions, obesity, and epidemiologic and lifestyle changes toward Westernization may have led to IRs increasing more in rural than in urban areas in Egypt. This pattern of increasing incidence in Egypt, which used to have a low incidence of uterine cancer, may appear in other middle-income countries that experience emerging nutritional and epidemiologic transitions. The rate of uterine cancer in urban areas in Gharbiah is almost similar to the corresponding rates globally. However, the rate in rural areas in this population has increased over the past decade but is still lower than the corresponding global rates. Future studies should examine the etiologic factors related to increasing rates in rural areas and quantify the improvement in rural case finding.


2014 ◽  
Vol 204 (6) ◽  
pp. 436-440 ◽  
Author(s):  
Ruoling Chen ◽  
Zhi Hu ◽  
Li Wei ◽  
Kenneth Wilson

BackgroundPeople from lower socioeconomic groups have a higher risk of mortality. The impact of low socioeconomic status on survival among older adults with dementia and depression remains unclear.AimsTo investigate the association between socioeconomic status and mortality in people with dementia and late-life depression in China.MethodUsing Geriatric Mental Status – Automated Geriatric Examination for Computer Assisted Taxonomy (GMS-AGECAT) we interviewed 2978 people aged ⩾60 years in Anhui, China. We characterised baseline socioeconomic status and risk factors and diagnosed 223 people with dementia and 128 with depression. All-cause mortality was followed up over 5.6 years.ResultsIndividuals with dementia living in rural areas had a three times greater risk of mortality (multivariate adjusted hazard ratio (HR) = 2.96, 95% CI 1.45–6.04) than those in urban areas, and for those with depression the HR was 4.15 (95% CI 1.59–10.83). There were similar mortality rates when comparing people with dementia with lowv.high levels of education, occupation and income, but individuals with depression with lowv.high levels had non-significant increases in mortality of 11%, 50% and 55% respectively.ConclusionsOlder adults with dementia and depression living in rural China had a significantly higher risk of mortality than urban counterparts. Interventions should be implemented in rural areas to tackle survival inequality in dementia and depression.


2017 ◽  
Vol 14 (127) ◽  
pp. 20160690 ◽  
Author(s):  
Jessica E. Steele ◽  
Pål Roe Sundsøy ◽  
Carla Pezzulo ◽  
Victor A. Alegana ◽  
Tomas J. Bird ◽  
...  

Poverty is one of the most important determinants of adverse health outcomes globally, a major cause of societal instability and one of the largest causes of lost human potential. Traditional approaches to measuring and targeting poverty rely heavily on census data, which in most low- and middle-income countries (LMICs) are unavailable or out-of-date. Alternate measures are needed to complement and update estimates between censuses. This study demonstrates how public and private data sources that are commonly available for LMICs can be used to provide novel insight into the spatial distribution of poverty. We evaluate the relative value of modelling three traditional poverty measures using aggregate data from mobile operators and widely available geospatial data. Taken together, models combining these data sources provide the best predictive power (highest r 2 = 0.78) and lowest error, but generally models employing mobile data only yield comparable results, offering the potential to measure poverty more frequently and at finer granularity. Stratifying models into urban and rural areas highlights the advantage of using mobile data in urban areas and different data in different contexts. The findings indicate the possibility to estimate and continually monitor poverty rates at high spatial resolution in countries with limited capacity to support traditional methods of data collection.


2019 ◽  
Vol 16 (1) ◽  
pp. 19-26 ◽  
Author(s):  
Prajjwal Pyakurel ◽  
Deepak Kumar Yadav ◽  
Jeevan Thapa ◽  
Nishant Thakur ◽  
Pramita Sharma ◽  
...  

Background: Hypertension is one of the major risk factors for the rising burden of cardiovascular diseases (CVDs) in developing region. It has also been recognized as one of the major public health problems in the developing countries since the early seventies and the rate is increasing not only in urban areas but in rural areas with low socio-economic condition.  Methods: A cross sectional study was conducted in Jogidaha Village Development Comittee(VDC) and Triyuga Municipality of Udaypur district of South-Eastern Nepal. A total of 430 participants of age 18-59 years were selected. Semi-structured questionnaire (WHO NCD STEPS instrument) was used to collect information on demographic variables and associated risk factors with use of show cards. Clinical and anthropometric measurement were done. Primary outcome was prevalence of hypertension. Bivariate and multivariate analysis were performed to show strength of association among various risk factors with hypertension.  Results: The prevalence of hypertension was found to be 25.1%. Prevalence of overweight and obesity was found to be 49.8%. Hypertension was significantly associated with age (AOR=1.09, CI=1.05-1.10) and gender (male >female; AOR= 2.12,CI =1.22-3.68). Similarly, increased waist-hip ratio(7.12; CI 2.87-17.67),alcohol consumption(OR=2.82,CI=1.77-4.52), and use of tobacco products (OR =1.8,CI=1.02-3.20) showed significant association with hypertension. Conclusion: There is high prevalence of hypertension in rural districts of South-Eastern Nepal. A community-based preventive approach with early detection and treatment and life-style modification is needed to reduce the burden of disease and make sustainable changes. 


Nutrients ◽  
2018 ◽  
Vol 11 (1) ◽  
pp. 14 ◽  
Author(s):  
Yoko Horiuchi ◽  
Kaoru Kusama ◽  
Sar Kanha ◽  
Nobuo Yoshiike ◽  

: 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.


2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Aufschnaiter ◽  
K Schindler ◽  
B Fuchs-Neuhold ◽  
K Maruszczak ◽  
E Pail ◽  
...  

Abstract Background Overweight and obesity in childhood and the associated secondary diseases are constantly on the increase. Studies show that the school environment can have an influence on the weight of children. The Childhood Obesity Surveillance Initiative (COSI) of the WHO is a Europe-wide epidemiological monitoring of anthropometric sizes of school children aged six to nine, with Austria participating in COSI for the first time in 2016. Methods A retrospective secondary data analysis based on two standardized questionnaires was performed. On the one hand, data on determinants specific to the school field were collected, on the other hand anthropometric data of children in third grade were measured. Across Austria, data from 97 schools and 2530 children were collected and evaluated using descriptive and inductive statistical methods. Results In 43,3 % of the schools, an existing playground can be used outside school opening hours. 73,2 % of the schools integrate nutrition education into their school curriculum either as a separate subject or in combination with another subject. Milk and dairy products are available in 60,8 % of schools, fresh fruit in 63,9 % and vegetables in 51,5 %. 28,3 % of the examined, 8 to 9-year-old children are overweight or obese (n = 658), while boys have a significant higher BMI than girls (p < 0,001). Also, in urban areas children have a significant higher BMI on average than in rural areas (p = 0,025). No significant relationship could be identified between the duration of physical education lessons per week and the BMI. However, a significant difference in childreńs BMI became visible when school playgrounds were also accessible outside opening hours (p = 0,018). Conclusions The alarming number of overweight children in Austria should be diminished through policies and further interventions. Schools can make a substantial contribution to this. The course of the development could be closely observed through possible further surveys by COSI. Key messages 73,2% of the schools include nutrition education in their curricula. Yet, about every third Austrian child aged between 8 and 9 is overweight, with boys being significantly more overweight than girls. If school playgrounds are accessible outside opening hours, the childreńs BMI is significantly lower. In urban areas, children have a significantly higher BMI than in rural areas.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Daisheng Tang ◽  
Tao Bu ◽  
Xuefan Dong

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.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e042654
Author(s):  
Yuxi Liu ◽  
Leni Kang ◽  
Chunhua He ◽  
Lei Miao ◽  
Xiaoqiong Qiu ◽  
...  

ObjectiveThe present study estimated the national and urban–rural levels and causes of neonatal deaths in China annually between 2014 and 2018 to provide data support for the further end of preventable neonatal deaths for China and other low-income and middle-income countries.MethodsThe study was based on data from the National Maternal and Child Health Surveillance System. All neonates of surveillance districts (gestational week: ≥28 weeks) who died after delivery have been involved in the study. The mortality rate and the leading causes of death for neonates were analysed.ResultsThe neonatal mortality rate (NMR) of China has steadily decreased from 5.9 deaths per 1000 live births in 2014 to 3.9 deaths per 1000 live births in 2018. The NMR in 2018 of urban and rural areas was 2.2 deaths per 1000 live births and 4.7 deaths per 1000 live births, respectively. The leading preventable causes of neonatal deaths are the same in the urban and rural areas were same, which were preterm birth, intrapartum complications and pneumonia. Mortality rates of these three causes fell significantly between 2014 and 2018 but contributed to a higher proportion of deaths in rural areas than urban areas. The proportion of preventable deaths accounted for 74.6% in 2018.ConclusionsThe NMR of China has decreased steadily from 2014 to 2018. However, the inequality between urban and rural areas still exists. The goal of government interventions should be to reduce the health inequality of neonates and further take targeted measures to eliminate preventable neonatal death.


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