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Influence of Obesity and Unemployment on Fertility Rates: A Multinational Analysis of 30 Countries from 1976 to 2014. J Clin Med 2022; 11:jcm11051152. [PMID: 35268243 PMCID: PMC8911065 DOI: 10.3390/jcm11051152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/06/2022] [Accepted: 02/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background: The rationale of a postulated decrease in fertility rate development is still being debated. Among the multiple influencing factors, socioeconomic variables and their complex influence are of particular interest. Methods: Data on socioeconomic and health variables from 1976−2014 of 30 countries within the OECD region were analysed for their respective influence on fertility rates by using mixed-effect regression models. Results: A significant negative influence of the increase in unemployment rate on the following year’s changes in fertility rate in Western (−0.00256; p < 0.001) as well as Eastern European (−0.0034; p < 0.001) countries was revealed. The effect of being overweight was significant for Western European (−0.00256; p < 0.001) countries only. When analysing the whole OECD region, an increase in unemployment retained its significant negative influence on the fertility rate (−0.0028; p < 0.001), while being overweight did not. Interestingly, divergent influences of time were revealed and fertility rates increased with time in Eastern Europe while they decreased in Western Europe. Conclusion: Importantly, a significant negative influence of increase in unemployment on the fertility rate was revealed—irrespective of the region and time analysed. Furthermore, an adverse effect of being overweight on the fertility rate in Western European countries was revealed. Interestingly, time was associated with a decreasing fertility rate in Western but not in Eastern Europe.
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Mazhar U, Rehman F. Productivity, obesity, and human capital: Panel data evidence. ECONOMICS AND HUMAN BIOLOGY 2022; 44:101096. [PMID: 34920362 DOI: 10.1016/j.ehb.2021.101096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/21/2021] [Accepted: 12/08/2021] [Indexed: 06/14/2023]
Abstract
The consequences of obesity for adults and children are well documented in the extant literature. We use panel data of 105 countries from 1990 to 2019 to estimate the effect of obesity on economic performance. We predict obesity using lagged values of child obesity as instruments. Predicted obesity has a negative and significant effect on productivity. This effect is independent of the effect of human capital and other macroeconomic determinants of economic performance. There is only weak evidence that this effect operates through the deterioration of human capital formation caused by childhood obesity.
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Affiliation(s)
- Ummad Mazhar
- Suleman Dawood School of Business (SDSB), Lahore University of Management Sciences (LUMS), Lahore, Pakistan.
| | - Fahd Rehman
- Suleman Dawood School of Business (SDSB), Lahore University of Management Sciences (LUMS), Lahore, Pakistan.
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Xin Y, Ren X. The Impact of Family Income on Body Mass Index and Self-Rated Health of Illiterate and Non-illiterate Rural Elderly in China: Evidence From a Fixed Effect Approach. Front Public Health 2021; 9:722629. [PMID: 34604161 PMCID: PMC8484635 DOI: 10.3389/fpubh.2021.722629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Rural communities worldwide are experiencing the most significant levels of aging. Most rural elderly have no stable pension, and leading family income plays an indispensable role in the life security of rural elderly. This study aims to investigate whether the association between annual family income per capita and body mass index (BMI) and self-rated health (SRH) in rural elderly is moderated by education during fast economic development. Methods: We chose the fixed-effects model to analyze the impact of the annual family income per capita change on BMI and SRH based on a large, nationally representative longitudinal dataset of rural respondents aged above 60 of the China Family Panel Studies (CFPS) from 2010 to 2018. Results: Six hundred and fifty-eight were eligible for inclusion in our analysis in CFPS. The median age of participants was 65 years in 2010, and 379 (57.60%) participants were male. Self-rated health increased with higher the logarithmized family income per capita among the rural illiterate elderly (β = 0.0770; 95% CI = 0.0065–0.1473). Body mass index increased with higher the logarithmized family income per capita among the rural elderly (β = 0.1614, 95% CI: 0.0325–0.2903), and it was more evident among the illiterate elderly (β = 0.2462, 95% CI: 0.05519–0.4372). Conclusion: Family income has an impact on BMI and SRH moderated by education level among rural elderly in China. These results contribute to developing more targeted strategies in the context of a developing country. In addition, it also reminds us to consider the differences in the educational level of the elderly in rural areas when examining the relationship between family income and health.
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Affiliation(s)
- Yu Xin
- Department of Health Behavioral and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Xiaohui Ren
- Department of Health Behavioral and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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Garas A, Guthmuller S, Lapatinas A. The development of nations conditions the disease space. PLoS One 2021; 16:e0244843. [PMID: 33411767 PMCID: PMC7790431 DOI: 10.1371/journal.pone.0244843] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/18/2020] [Indexed: 02/08/2023] Open
Abstract
Using the economic complexity methodology on data for disease prevalence in 195 countries during the period of 1990-2016, we propose two new metrics for quantifying the disease space of countries. With these metrics, we analyze the geography of diseases and empirically investigate the effect of economic development on the health complexity of countries. We show that a higher income per capita increases the complexity of countries’ diseases. We also show that complex diseases tend to be non-ubiquitous diseases that are prevalent in disease-diversified (complex) countries, while non-complex diseases tend to be non-ubiquitous diseases that are prevalent in non-diversified (non-complex) countries. Furthermore, we build a disease-level index that links a disease to the average level of GDP per capita of the countries in which the disease is prevalent. With this index, we highlight the link between economic development and the complexity of diseases and illustrate how increases in income per capita are associated with more complex diseases.
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Affiliation(s)
- Antonios Garas
- Chair of Systems Design, ETH Zurich, Zurich, Switzerland
| | - Sophie Guthmuller
- Joint Research Centre, European Commission, Ispra, VA, Italy
- Health Economics and Policy Group, Institute for Social Policy, Department of Socioeconomics, Vienna University of Economics and Business, Vienna, Austria
- RWI Research Network, RWI Essen, Essen, Germany
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The overweight and obesity transition from the wealthy to the poor in low- and middle-income countries: A survey of household data from 103 countries. PLoS Med 2019; 16:e1002968. [PMID: 31774821 PMCID: PMC6880978 DOI: 10.1371/journal.pmed.1002968] [Citation(s) in RCA: 103] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 10/29/2019] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In high-income countries, obesity prevalence (body mass index greater than or equal to 30 kg/m2) is highest among the poor, while overweight (body mass index greater than or equal to 25 kg/m2) is prevalent across all wealth groups. In contrast, in low-income countries, the prevalence of overweight and obesity is higher among wealthier individuals than among poorer individuals. We characterize the transition of overweight and obesity from wealthier to poorer populations as countries develop, and project the burden of overweight and obesity among the poor for 103 countries. METHODS AND FINDINGS Our sample used 182 Demographic and Health Surveys and World Health Surveys (n = 2.24 million respondents) from 1995 to 2016. We created a standard wealth index using household assets common among all surveys and linked national wealth by country and year identifiers. We then estimated the changing probability of overweight and obesity across every wealth decile as countries' per capita gross domestic product (GDP) rises using logistic and linear fixed-effect regression models. We found that obesity rates among the wealthiest decile were relatively stable with increasing national wealth, and the changing gradient was largely due to increasing obesity prevalence among poorer populations (3.5% [95% uncertainty interval: 0.0%-8.3%] to 14.3% [9.7%-19.0%]). Overweight prevalence among the richest (45.0% [35.6%-54.4%]) and the poorest (45.5% [35.9%-55.0%]) were roughly equal in high-income settings. At $8,000 GDP per capita, the adjusted probability of being obese was no longer highest in the richest decile, and the same was true of overweight at $10,000. Above $25,000, individuals in the richest decile were less likely than those in the poorest decile to be obese, and the same was true of overweight at $50,000. We then projected overweight and obesity rates by wealth decile to 2040 for all countries to quantify the expected rise in prevalence in the relatively poor. Our projections indicated that, if past trends continued, the number of people who are poor and overweight will increase in our study countries by a median 84.4% (range 3.54%-383.4%), most prominently in low-income countries. The main limitations of this study included the inclusion of cross-sectional, self-reported data, possible reverse causality of overweight and obesity on wealth, and the lack of physical activity and food price data. CONCLUSIONS Our findings indicate that as countries develop economically, overweight prevalence increased substantially among the poorest and stayed mostly unchanged among the wealthiest. The relative poor in upper- and lower-middle income countries may have the greatest burden, indicating important planning and targeting needs for national health programs.
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Luo W, Xie Y. Variation in the education gradient of body weight in contemporary China. ACTA ACUST UNITED AC 2018. [DOI: 10.1177/2057150x18782639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using data from the 1991–2009 China Health and Nutrition Surveys, this paper examines the temporal–spatial variation in the education gradient of body weight relative to height among Chinese adults, and how the variation is associated with levels of economic development. We find different variation patterns for men and women. For women, the education gradient in body weight shifted from being positive to being negative over time for China as a whole, as well as across regions with different levels of economic development. In contrast, for men, higher education remained consistently associated with higher body weight over the 18-year period studied in China as a whole, as well as across regions with different levels of economic development.
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Affiliation(s)
- Weixiang Luo
- Institute of Population Research, Fudan University, Shanghai, People’s Republic of China
| | - Yu Xie
- Department of Sociology, Princeton University, NJ, USA
- Center for Social Research, Peking University, Beijing, People’s Republic of China
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Bahreynian M, Motlagh ME, Qorbani M, Heshmat R, Ardalan G, Kelishadi R. Prevalence of Growth Disorders in a Nationally Representative Sample of Iranian Adolescents According to Socioeconomic Status: The CASPIAN-III Study. Pediatr Neonatol 2015; 56:242-7. [PMID: 25603727 DOI: 10.1016/j.pedneo.2014.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 09/18/2014] [Accepted: 12/15/2014] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aims to assess the prevalence of growth disorders among a nationally representative sample of Iranian adolescents according to the socioeconomic status (SES) of their living area. METHODS This nationwide cross-sectional survey was conducted among a representative sample of 5624 adolescents aged 10-18 years. They were selected by multistage cluster sampling from 27 provinces of Iran. Subnational classification of the country was based on geography and social class of each region. Analysis of variance and Chi-square tests were used to compare the prevalence of growth disorders according to sex and SES of the living regions. RESULTS The mean and standard deviation for body mass index was 19.42 (4.09) kg/m(2), with a significant trend from the Southeast region with lowest SES to the Central part with highest SES (p(trend) < 0.001). The prevalence of obesity, combined overweight and obesity, as well as abdominal adiposity increased with a significant trend from low to high SES (all p(trend) < 0.001, except for girls' height, p(trend) = 0.003). The opposite direction was documented for the prevalence of underweight and short stature, with the highest frequencies in the Southeast (lowest SES) and the lowest in Central part (highest SES). CONCLUSION Excess weight was more prevalent in high SES regions, whereas underweight and short stature were more prevalent in low SES regions. These findings underscore the necessity of implementing evidence-based health promotion programs and preventive strategies according to SES.
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Affiliation(s)
- Maryam Bahreynian
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran; Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Gelayol Ardalan
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Pediatrics Department, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
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Kinge JM, Strand BH, Vollset SE, Skirbekk V. Educational inequalities in obesity and gross domestic product: evidence from 70 countries. J Epidemiol Community Health 2015; 69:1141-6. [PMID: 26179449 DOI: 10.1136/jech-2014-205353] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 06/26/2015] [Indexed: 11/03/2022]
Abstract
BACKGROUND We test the reversal hypothesis, which suggests that the relationship between obesity and education depends on the economic development in the country; in poor countries, obesity is more prevalent in the higher educated groups, while in rich countries the association is reversed-higher prevalence in the lower educated. METHODS We assembled a data set on obesity and education including 412,921 individuals from 70 countries in the period 2002-2013. Gross domestic product (GDP) per capita was used as a measure of economic development. We assessed the association between obesity and GDP by education using a two-stage mixed effects model. Country-specific educational inequalities in obesity were investigated using regression-based inequality indices. RESULTS The reversal hypothesis was supported by our results in men and women. Obesity was positively associated with country GDP only among individuals with lower levels of education, while this association was absent or reduced in those with higher levels of education. This pattern was more pronounced in women than in men. Furthermore, educational inequalities in obesity were reversed with GDP; in low-income countries, obesity was more prevalent in individuals with higher education, in medium-income and high-income countries, obesity shifts to be more prevalent among those with lower levels of education. CONCLUSIONS Obesity and economic development were positively associated. Our findings suggest that education might mitigate this effect. Global and national action aimed at the obesity epidemic should take this into account.
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Affiliation(s)
- Jonas Minet Kinge
- Norwegian Institute of Public Health, Oslo, Norway Department of Health Management and Health Economics, University of Oslo, Oslo, Norway
| | - Bjørn Heine Strand
- Norwegian Institute of Public Health, Oslo, Norway Department of Community Medicine, University of Oslo, Oslo, Norway
| | - Stein Emil Vollset
- Norwegian Institute of Public Health, Oslo, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Vegard Skirbekk
- Norwegian Institute of Public Health, Oslo, Norway Columbia Aging Center, Columbia University, New York, New York, USA
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