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Risk of eating disorders in a representative sample of Italian adolescents: prevalence and association with self-reported interpersonal factors. Eat Weight Disord 2022; 27:701-708. [PMID: 34014507 PMCID: PMC8933299 DOI: 10.1007/s40519-021-01214-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/11/2021] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Adolescence represents a critical period for the onset of eating disorders (EDs). The present study aimed to provide the prevalence of individuals at risk for EDs psychopathology in a representative population of adolescents aged 14-19 and to characterize this population regarding interpersonal and psychological factors. METHODS The percentage of participants at risk for EDs in a representative high school population was assessed through the SCOFF screening questionnaire (cut-off score: 3) in the total sample (N: 6551) and in gender-based subgroups for different body mass index (BMI) categories. Odds ratios for being at risk of ED (SCOFF ≥ 3) were esteemed in a multivariable analysis including self-reported parental education, quality of family and peer relationships, bullying victimization, age at first sexual intercourse, and psychological distress. RESULTS A SCOFF score ≥ 3 was found in 31.0% of participants (boys: 19.4%; girls: 44.6%), with a greater prevalence among higher BMI categories. Bad family relationships, being bullied, having the first sexual intercourse before the age of 14, and experiencing high distress were associated with this risk condition. Among girls, bad peer relationships were associated with a low-risk SCOFF score. CONCLUSION A remarkable percentage of adolescents reported significant body image or eating concerns. Screening programs are deeply needed, and particular attention should be devoted to interpersonal factors, such as the quality of family relationships and interactions with peers, which represent potential indicators of this vulnerability. LEVEL OF EVIDENCE Level V - Cross-sectional study.
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Colombet Z, Simioni M, Drogue S, Lamani V, Perignon M, Martin-Prevel Y, Merle S, Amiot MJ, Darmon N, Soler LG, Méjean C. Demographic and socio-economic shifts partly explain the Martinican nutrition transition: an analysis of 10-year health and dietary changes (2003-2013) using decomposition models. Public Health Nutr 2021; 24:1-12. [PMID: 34551851 DOI: 10.1017/s136898002100327x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The Caribbean has seen a dramatic shift in the obesity and chronic disease prevalence over the past decades, suggesting a nutrition transition. Simultaneously, Martinique has faced a demographic transition marked by significant population ageing. We aimed to differentiate the contribution of changes in health status and dietary intakes due to shifts in demographic and socio-economic characteristics (DSEC) from that due to unobserved factors. DESIGN Two cross-sectional surveys conducted in 2003 (n 743) and 2013 (n 573) on representative samples were used. Dietary intakes were estimated by 24-h recalls. The contribution of changes in health status and dietary intakes due to shifts in observed DSEC was differentiated from that due to unobserved factors over a 10-year interval, using Oaxaca-Blinder decomposition models. SETTING Martinique, French region in the Caribbean. PARTICIPANTS Martinican adults (≥16 years). RESULTS Over the study period, health status deteriorated, partly owing to shifts in DSEC, explaining 62 % of the change in the prevalence of hypertension (+13 percentage points (pp)) and 48 % of waist circumference change (+3 cm). Diet quality decreased (mean adequacy ratio -2pp and mean excess ratio + 2 pp) and energy supplied by ultra-processed food increased (+4 pp). Shifts in DSEC marginally explained some changes in dietary intakes (e.g. increased diet quality), while the changes that remained unexplained were of opposite sign, with decreased diet quality, lower fruits, tubers and fish intakes and higher energy provided by ultra-processed foods. CONCLUSION Explained dietary changes were of opposite sign to nutrition transition conceptual framework, probably because unobserved drivers are in play, such as food price trends or supermarkets spread.
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Affiliation(s)
- Zoé Colombet
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | - Michel Simioni
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | - Sophie Drogue
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | - Viola Lamani
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | - Marlène Perignon
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | - Yves Martin-Prevel
- Nutripass, Université de Montpellier, IRD, Montpellier SupAgro, Montpellier, France
| | - Sylvie Merle
- Regional Observatory on Health, Schoelcher, Martinique, France
- Department of Clinical Research and Innovation, University Hospital of Martinique, Fort-de-France, Martinique, France
| | - Marie-Josèphe Amiot
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | - Nicole Darmon
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
| | | | - Caroline Méjean
- MOISA, Université de Montpellier, CIRAD, CIHEAM-IAMM, INRAE, Montpellier SupAgro, UMR 1110 MOISA, 2 Place Pierre-Viala, Montpellier34000, France
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Body weight trends in adolescents of Central Italy across 13 years: social, behavioural, and psychological correlates. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01627-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Aim
The study aimed to determine trends in the prevalence of underweight, overweight, obesity and their putative risk factors in different cohorts from a representative population of adolescents in Central Italy.
Subject and methods
After random sampling, five cohorts of adolescents attending public high schools – aged 14 to 18 years – were evaluated from 2005 to 2018 (n: 25,174). Collected information included self-reported body mass index (BMI), descriptors of family environment, eating behaviour, physical activity, screen use, bullying victimisation, sexual behaviour (age at first intercourse, number of partners) and perceived psychological distress. For these data, between-cohort prevalence differences were used to esteem prevalence variations across time. In the 2018 cohort, the association between these factors and body weight was evaluated through multinomial regressions with sex-specific crude relative risk ratios for different BMI categories.
Results
An increased prevalence of overweight was observed for both boys and girls. The study outlined a transition towards higher parental education and unemployment, reduced soft drinks consumption and higher psychological distress. Sex-specific changes were observed for physical and sexual activity, and a rising percentage of girls reported being bullied and distressing family relationships. Parental education and employment, together with physical activity, confirmed to be protective factors against pathological weight. The latter clustered with reduced soft drinks consumption, bullying victimisation, early sexual activity, worse family relationships and higher distress.
Conclusion
An increased prevalence of both overweight and underweight was observed across time. Economic factors associated with unemployment and changes in behavioural patterns may have contributed to this trend.
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Miyawaki A, Evans CEL, Lucas PJ, Kobayashi Y. Relationships between social spending and childhood obesity in OECD countries: an ecological study. BMJ Open 2021; 11:e044205. [PMID: 33622950 PMCID: PMC7907862 DOI: 10.1136/bmjopen-2020-044205] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES The burden of childhood obesity is clustered among children in low-socioeconomic groups. Social spending on children-public welfare expenditure on families and education-may curb childhood obesity by reducing socioeconomic disadvantages. The objective of this study was to examine the relationship between social spending on children and childhood obesity across the Organisation for Economic Cooperation and Development (OECD) countries. DESIGN Ecological study. SETTING Data on social spending on children were obtained from the OECD Social Expenditure Database and the OECD educational finance indicators dataset during 2000-2015. Data on childhood obesity were obtained from the NCD Risk Factor Collaboration database. PARTICIPANTS Aggregated statistics on obesity among children aged 5-19 years, estimated for OECD 35 countries based on the measured height and weight on 31.5 million children. OUTCOME MEASURES Country-level prevalence of obesity among children aged 5-19 years. RESULTS In cross-sectional analyses in 2015, social spending on children was inversely associated with the prevalence of childhood obesity after adjusting for potential confounders (the gross domestic product per capita, unemployment rate, poverty rate, percentage of children aged <20 years and prevalence of childhood obesity in 2000). In addition, when we focused on changes from 2000 to 2015, an average annual increase of US$100 in social spending per child was associated with a decrease in childhood obesity by 0.6 percentage points for girls (p=0.007) and 0.7 percentage points for boys (p=0.04) between 2000 and 2015, after adjusting for the potential confounders. The dimensions of social spending that contributed to these associations between the changes in social spending on children and childhood obesity were early childhood education and care (ECEC) and school education for girls and ECEC for boys. CONCLUSION Countries that increase social spending on children tend to experience smaller increases in childhood obesity.
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Affiliation(s)
- Atsushi Miyawaki
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Health Services Research and Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | | | | | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
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Yang Y, Deng H, Yang Q, Ding X, Mao D, Ma X, Xiao B, Zhong Z. Mental health and related influencing factors among rural elderly in 14 poverty state counties of Chongqing, Southwest China: a cross-sectional study. Environ Health Prev Med 2020; 25:51. [PMID: 32912134 PMCID: PMC7488569 DOI: 10.1186/s12199-020-00887-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 08/24/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND China has the largest elderly population in the world; little attention has been paid to the mental health of elderly in areas of extreme poverty. This is the first study to investigate the mental health of the rural elderly in poverty state counties in Chongqing and was part of the Chongqing 2018 health literacy promotion project. METHODS In 2019, a cross-sectional study was conducted to investigate the mental health status of the rural elderly in fourteen poverty state counties of Chongqing, in which a total of 1400 elderly aged ≥ 65 years were interviewed, where mental health status was measured by the ten-item Kessler10 (K10) scale. Ordered multivariate logistic regression was performed to evaluate the influencing factors related to mental health of the elderly in these areas. RESULTS The average score of K10 in 14 poverty state counties was 17.40 ± 6.31, 47.6% was labeled as good, 30.2% was moderate, 17.0% was poor, and lastly 5.1% was bad, and the mental health status of the elderly in the northeastern wing of Chongqing was better than the one in the southeastern wing of Chongqing. A worse self-rated health was the risk factor for mental health both in the northeastern and southeastern wings of Chongqing (all P < 0.001). Lower education level (OR (95% CI) = 1.45 (1.12-1.87), P = 0.004) was a risk factor in the northeastern wing, whereas older age (OR (95% CI) = 1.33 (1.13-1.56), P = 0.001) was a risk factors in the southeastern wing. CONCLUSIONS The results showed that mental health of the elderly in poverty state counties was poor, especially in the southeastern wing of Chongqing. Particular attention needs to be paid to the males who were less educated, older, and single; female with lower annual per capital income; and especially the elderly with poor self-rated health.
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Affiliation(s)
- Yin Yang
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, YiXueYuan Road, YuZhong District, Chongqing, 400016, China
| | - Hui Deng
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qingqing Yang
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, YiXueYuan Road, YuZhong District, Chongqing, 400016, China
| | - Xianbin Ding
- Chongqing Preventive Medicine Association, Chongqing, China.,Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Deqiang Mao
- Chongqing Preventive Medicine Association, Chongqing, China.,Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xiaosong Ma
- Chongqing Preventive Medicine Association, Chongqing, China.,Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Bangzhong Xiao
- Chongqing Preventive Medicine Association, Chongqing, China.,Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Zhaohui Zhong
- Department of Epidemiology, School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, YiXueYuan Road, YuZhong District, Chongqing, 400016, China.
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Duncan R, Toledo P. Inequality in body mass indices across countries: Evidence from convergence tests. ECONOMICS AND HUMAN BIOLOGY 2019; 33:40-57. [PMID: 30685739 DOI: 10.1016/j.ehb.2018.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/03/2018] [Accepted: 10/25/2018] [Indexed: 06/09/2023]
Abstract
This study examines the long-term inequality in body mass index (BMI) based on convergence tests applied to a database of 172 countries recently published by the NCD Risk Factor Collaboration. First, we find that countries converge in clubs, which indicates that country disparities in BMIs will persist over time. Second, there are three and six convergence clubs in BMIs for female and male individuals, respectively. That is, we would not observe a single convergence pattern in body weights as the nutrition transition theory and the dietary convergence hypothesis seem to suggest. Females have only one healthy club (18.5 ≤ BMI < 25) and two overweight clubs (BMI ≥ 25). Males have three healthy clubs and three overweight clubs. Third, the analysis of club convergence indicates that BMI inequality has increased due to the BMI growth observed in club 1 (the one with the highest average BMI and led by the US) in each gender group. Finally, potential determinants of BMI such as globalization, human capital, income, and urbanization are relevant to understand differences across clubs. We interpret the club convergence as the result of a heterogeneous integration of countries into the global economy, which is probably related to strong domestic preferences, policies designed to manage the impacts of globalization, and shifts in productive structures.
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Affiliation(s)
- Roberto Duncan
- Department of Economics, Ohio University, Bentley Annex 349, United States.
| | - Patricia Toledo
- Department of Economics, Ohio University, Bentley Annex 345, United States.
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Vahid Shahidi F, Muntaner C, Shankardass K, Quiñonez C, Siddiqi A. Widening health inequalities between the employed and the unemployed: A decomposition of trends in Canada (2000-2014). PLoS One 2018; 13:e0208444. [PMID: 30496288 PMCID: PMC6264881 DOI: 10.1371/journal.pone.0208444] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 11/16/2018] [Indexed: 12/31/2022] Open
Abstract
Recent developments in the social epidemiological literature indicate that health inequalities between the employed and the unemployed are widening in many advanced capitalist countries. At present, we know relatively little about why these inequalities are worsening. Drawing on nationally-representative data from the largest health survey in Canada, we explored this question by analyzing changes in self-rated health inequalities between employed and unemployed Canadians from 2000 to 2014. Using a regression-based method that decomposes a given inequality into its component sources, we investigated the extent to which risk factors that account for unemployment-related health inequalities at a single point in time can also explain the extent and direction of change in these unemployment-related health inequalities over time. Our results indicate that relative and absolute health inequalities between employed and unemployed Canadians widened over the study period. Between 2000 and 2014, the prevalence of poor self-rated health among unemployed Canadians increased from 10.8% to 14.6%, while rates among employed Canadians were stable at around 6%. Our findings suggest that the demographic, socioeconomic, and proximal risk factors that are routinely used to explain unemployment-related health inequalities may not be as powerful for explaining how and why these inequalities change over time. In the case of unemployment-related health inequalities in Canada, these risk factors explain neither the increasing prevalence of poor self-rated health among the unemployed nor the growing gap between the unemployed and their employed counterparts. We provide several possible explanations for these puzzling findings. We conclude by suggesting that widening health inequalities may be driven by macrosocial trends (e.g. widening income inequality and declining social safety nets) which have changed the meaning and context of unemployment, as well as its associated risk factors, in ways that are not easy to capture using routinely available survey data.
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Affiliation(s)
- Faraz Vahid Shahidi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Carles Muntaner
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Bloomberg School of Nursing, University of Toronto, Toronto, Ontario, Canada
| | - Ketan Shankardass
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Health Sciences, Wilfrid Laurier University, Waterloo, Ontario, Canada
| | - Carlos Quiñonez
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Gillings School of Public Health, University of Northern Carolina, Chapel Hill, North Carolina, United States of America
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Trinh Thi H, Simioni M, Thomas-Agnan C. Decomposition of changes in the consumption of macronutrients in Vietnam between 2004 and 2014. ECONOMICS AND HUMAN BIOLOGY 2018; 31:259-275. [PMID: 30326404 DOI: 10.1016/j.ehb.2018.09.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 08/13/2018] [Accepted: 09/16/2018] [Indexed: 06/08/2023]
Abstract
Vietnam is undergoing a nutritional transition like many middle-income countries. This transition is characterized by an increase in per capita total calorie intake resulting from an increase in the consumption of fat and protein while the carbohydrate consumption decreases. This paper proposes to highlight the sociodemographic drivers of this transition over the period 2004-2014, using Vietnam Household Living Standard Survey data. We implement a method of decomposition of between-year differences in economic outcomes recently proposed in the literature. This method decomposes the between-year change in various indicators related to the outcome distribution (mean, median, quantiles, etc.) into (1) the effect due to between-year change in the conditional distribution of the outcome given sociodemographic characteristics, or "structure effect", and (2) the effect due to the differences in sociodemographic characteristics across years, or "composition effect". In turn, this last effect is decomposed into direct contributions of each sociodemographic characteristics and effects of their interactions. The composition effect, always positive, generally outweighs the structure effect when considering the between-year changes in distributions of per capita calorie intake or calorie intake coming from protein or fat. The effects of changes in the composition of the Vietnamese population thus overcome the effects of changes in preferences of the same population. This finding is reversed in the case of carbohydrates. Food expenditure and household size appear to be the main contributors to the composition effect. The positive effects of these two variables explain well most of the between-year shifts observed in the calorie intake distributions. Urbanization and level of education contribute negatively to the composition effect, with the noticeable exception of fat where the effect of urbanization is positive. But these two variables effects are negligible compared to those of food expenditure and household size.
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Affiliation(s)
- Huong Trinh Thi
- Institute of Research and Development, Duy Tan University, Da Nang 550000, Viet Nam; International Center for Tropical Agriculture (CIAT), Hanoi, Viet Nam.
| | - Michel Simioni
- MOISA, INRA, University of Montpellier, Montpellier, France; IREEDS-VCREME, Hanoi, Viet Nam
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9
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Duncan R, Toledo P. Long-run overweight levels and convergence in body mass index. ECONOMICS AND HUMAN BIOLOGY 2018; 31:26-39. [PMID: 30077042 DOI: 10.1016/j.ehb.2018.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/25/2018] [Accepted: 06/21/2018] [Indexed: 06/08/2023]
Abstract
We evaluate the hypothesis of convergence to an optimal long-run body weight worldwide. We formulate a simple rational non-addiction eating model to derive a testable equation that allows us to verify the existence of a long-run body weight as well as its estimation. We use a database of body mass index (BMI) estimates across countries over four decades published by the NCD Risk Factor Collaboration. We find that BMIs converge among European countries but not in the rest of the world. Consistent with the theoretical model, our long-run estimates suggest that European nations will show an average BMI above healthy levels. In particular, females and males will show average BMIs classified as overweight levels (BMI = 28.3). Confidence intervals and sensitivity analysis suggest that males might reach long-term BMI levels associated with obesity (BMI > 30). We discuss the implications of our findings from the perspectives of health economics and economic development.
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Affiliation(s)
- Roberto Duncan
- Department of Economics, Ohio University, Bentley Annex 349, Athens, Ohio, United States.
| | - Patricia Toledo
- Department of Economics, Ohio University, Bentley Annex 345, Athens, Ohio, United States.
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Dursun B, Cesur R, Mocan N. The Impact of Education on Health Outcomes and Behaviors in a Middle-Income, Low-Education Country. ECONOMICS AND HUMAN BIOLOGY 2018; 31:94-114. [PMID: 30170298 DOI: 10.1016/j.ehb.2018.07.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 06/28/2018] [Accepted: 07/17/2018] [Indexed: 06/08/2023]
Abstract
Although the impact of education on health is important for public policy everywhere, the overwhelming majority of research identifying the health returns to education has focused on developed countries. We use data from multiple waves of nationally-representative Health and Tobacco Surveys in Turkey, and exploit an education reform that increased the mandatory years of schooling from 5 to 8 years in 1997. Using exposure to the reform as an instrument for completing at least eight years of schooling, we examine the impact of education on health indicators and smoking among young adults. We find that extending schooling on this margin impacts men and women differently. Our results indicate that while a one-year of extra schooling increases the likelihood of being obese among males by 9.9 percentage points, the same increase in schooling improves the probability of women being in the healthy weight range by 15.5 percentage points. Consistent with this result, an extra year of education increases women's propensity to self-evaluate their health as excellent by 4.3 percentage points. Additional analyses reveal that education makes men (but not women) more likely to spend time on computers, using the internet, and to spend time on social media, suggesting that differential time allocation between men and women, triggered by enhanced education, may be a mechanism behind the differential results between the sexes. Education has no impact on smoking for men or women regardless of the measure of smoking.
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Affiliation(s)
| | - Resul Cesur
- University of Connecticut and NBER, United States.
| | - Naci Mocan
- Louisiana State University, NBER and IZA, United States.
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Besides Depression, Number of Physiological Diseases is More Important than Physical Function on Mental Health of Elderly Adults in Taiwan. Community Ment Health J 2018; 54:204-210. [PMID: 28150081 DOI: 10.1007/s10597-017-0090-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 01/09/2017] [Indexed: 12/31/2022]
Abstract
This study contrasted the relative importance between the number of physiological diseases and activities of daily living (ADLs) to the mental health of elderly adults after controlling for mini-mental state exam (MMSE) scores and depression. Participants were 1342 elderly people with a mean age of 73.22 years and living in three communities in southern Taiwan. Age, gender, years of education duration, marital status, and MMSE and hamilton depression rating scale (HAMD) scores were control variables. The ability of the ADLs scale scores and number of physiological diseases to predict mental health, as measured by the 12-item Chinese health questionnaire, was compared using hierarchical regression analyses. The final hierarchical model indicated that only HAMD and the number of physiological diseases scores were significant and that the former was much more predictive than the latter. The results imply that the number of physiological diseases is more predictive of mental health than ADLs scores and that depression is a dangerous risk factor for elderly people.
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12
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Apouey BH, Geoffard PY. Parents' education and child body weight in France: The trajectory of the gradient in the early years. ECONOMICS AND HUMAN BIOLOGY 2016; 20:70-89. [PMID: 26656206 DOI: 10.1016/j.ehb.2015.10.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 10/10/2015] [Accepted: 10/12/2015] [Indexed: 06/05/2023]
Abstract
This paper explores the relationship between parental education and offspring body weight in France. Using two large datasets spanning the 1991-2010 period, we examine the existence of inequalities in maternal and paternal education and reported child body weight measures, as well as their evolution across childhood. Our empirical specification is flexible and allows this evolution to be non-monotonic. Significant inequalities are observed for both parents' education--maternal (respectively paternal) high education is associated with a 7.20 (resp. 7.10) percentage points decrease in the probability that the child is reported to be overweight or obese, on average for children of all ages. The gradient with respect to parents' education follows an inverted U-shape across childhood, meaning that the association between parental education and child body weight widens from birth to age 8, and narrows afterward. Specifically, maternal high education is correlated with a 5.30 percentage points decrease in the probability that the child is reported to be overweight or obese at age 2, but a 9.62 percentage points decrease at age 8, and a 1.25 percentage point decrease at age 17. The figures for paternal high education are respectively 5.87, 9.11, and 4.52. This pattern seems robust, since it is found in the two datasets, when alternative variables for parental education and reported child body weight are employed, and when controls for potential confounding factors are included. The findings for the trajectory of the income gradient corroborate those of the education gradient. The results may be explained by an equalization in actual body weight across socioeconomic groups during youth, or by changes in reporting styles of height and weight.
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Affiliation(s)
- Bénédicte H Apouey
- Paris School of Economics - CNRS, 48, Boulevard Jourdan, 75014 Paris, France.
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Dutton DJ, McLaren L. How important are determinants of obesity measured at the individual level for explaining geographic variation in body mass index distributions? Observational evidence from Canada using Quantile Regression and Blinder-Oaxaca Decomposition. J Epidemiol Community Health 2015; 70:367-73. [PMID: 26646691 DOI: 10.1136/jech-2015-205790] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/02/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Obesity prevalence varies between geographic regions in Canada. The reasons for this variation are unclear but most likely implicate both individual-level and population-level factors. The objective of this study was to examine whether equalising correlates of body mass index (BMI) across these geographic regions could be reasonably expected to reduce differences in BMI distributions between regions. METHODS Using data from three cycles of the Canadian Community Health Survey (CCHS) 2001, 2003 and 2007 for males and females, we modelled between-region BMI cross-sectionally using quantile regression and Blinder-Oaxaca decomposition of the quantile regression results. RESULTS We show that while individual-level variables (ie, age, income, education, physical activity level, fruit and vegetable consumption, smoking status, drinking status, family doctor status, rural status, employment in the past 12 months and marital status) may be Caucasian important correlates of BMI within geographic regions, those variables are not capable of explaining variation in BMI between regions. DISCUSSION Equalisation of common correlates of BMI between regions cannot be reasonably expected to reduce differences in the BMI distributions between regions.
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Affiliation(s)
- Daniel J Dutton
- The Prentice Institute for Global Population & Economy, Lethbridge, Alberta, Canada
| | - Lindsay McLaren
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
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Fiorillo D, Sabatini F. Structural social capital and health in Italy. ECONOMICS AND HUMAN BIOLOGY 2015; 17:129-142. [PMID: 25805101 DOI: 10.1016/j.ehb.2015.02.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 01/21/2015] [Accepted: 02/23/2015] [Indexed: 06/04/2023]
Abstract
This paper presents the first empirical assessment of the causal relationship between social capital and health in Italy. The analysis draws on the 2000 wave of the Multipurpose Survey on Household conducted by the Italian Institute of Statistics on a representative sample of the population (n=46,868). Our measure of social capital is the frequency of meetings with friends. Based on IV and bivariate probit estimates, we find that individuals who meet friends every day or more time times a week are approximately 11-16% more likely to report good health.
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Affiliation(s)
- Damiano Fiorillo
- Department of Business and Economics, University of Napoli Parthenope, Italy; Health, Econometrics and Data Group, University of York, United Kingdom.
| | - Fabio Sabatini
- Department of Economics and Law, Sapienza University of Rome, Italy; Laboratory for Comparative Social Research, National Research University Higher School of Economics, Russian Federation.
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15
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Averett SL, Stacey N, Wang Y. Decomposing race and gender differences in underweight and obesity in South Africa. ECONOMICS AND HUMAN BIOLOGY 2014; 15:23-40. [PMID: 25434513 DOI: 10.1016/j.ehb.2014.05.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Revised: 05/12/2014] [Accepted: 05/12/2014] [Indexed: 06/04/2023]
Abstract
Using data from the National Income Dynamics Study, we document differentials in both underweight and obesity across race and gender in post-Apartheid South Africa. Using a nonlinear decomposition method, we decompose these differences across gender within race and then across race within gender. Less than one third of the differences in obesity and underweight across gender are explained by differences in covariates. In contrast, at least 70% of the obesity differences across race are explained by differences in covariates. Behavioral variables such as smoking and exercise explain the largest part of the bodyweight differentials across gender. For bodyweight differentials across race within gender, however, socioeconomic status and background variables have the largest explanatory power for obesity differentials, while background variables play the key role in explaining the underweight differentials. These results indicate that eradicating obesity and underweight differentials will require targeting policies to specific groups.
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Affiliation(s)
| | | | - Yang Wang
- Lafayette College, Easton, PA 18042, United States.
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16
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Srinivasan CS, Zanello G, Shankar B. Rural-urban disparities in child nutrition in Bangladesh and Nepal. BMC Public Health 2013; 13:581. [PMID: 23767425 PMCID: PMC3729423 DOI: 10.1186/1471-2458-13-581] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Accepted: 05/15/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The persistence of rural-urban disparities in child nutrition outcomes in developing countries alongside rapid urbanisation and increasing incidence of child malnutrition in urban areas raises an important health policy question - whether fundamentally different nutrition policies and interventions are required in rural and urban areas. Addressing this question requires an enhanced understanding of the main drivers of rural-urban disparities in child nutrition outcomes especially for the vulnerable segments of the population. This study applies recently developed statistical methods to quantify the contribution of different socio-economic determinants to rural-urban differences in child nutrition outcomes in two South Asian countries - Bangladesh and Nepal. METHODS Using DHS data sets for Bangladesh and Nepal, we apply quantile regression-based counterfactual decomposition methods to quantify the contribution of (1) the differences in levels of socio-economic determinants (covariate effects) and (2) the differences in the strength of association between socio-economic determinants and child nutrition outcomes (co-efficient effects) to the observed rural-urban disparities in child HAZ scores. The methodology employed in the study allows the covariate and coefficient effects to vary across entire distribution of child nutrition outcomes. This is particularly useful in providing specific insights into factors influencing rural-urban disparities at the lower tails of child HAZ score distributions. It also helps assess the importance of individual determinants and how they vary across the distribution of HAZ scores. RESULTS There are no fundamental differences in the characteristics that determine child nutrition outcomes in urban and rural areas. Differences in the levels of a limited number of socio-economic characteristics - maternal education, spouse's education and the wealth index (incorporating household asset ownership and access to drinking water and sanitation) contribute a major share of rural-urban disparities in the lowest quantiles of child nutrition outcomes. Differences in the strength of association between socio-economic characteristics and child nutrition outcomes account for less than a quarter of rural-urban disparities at the lower end of the HAZ score distribution. CONCLUSIONS Public health interventions aimed at overcoming rural-urban disparities in child nutrition outcomes need to focus principally on bridging gaps in socio-economic endowments of rural and urban households and improving the quality of rural infrastructure. Improving child nutrition outcomes in developing countries does not call for fundamentally different approaches to public health interventions in rural and urban areas.
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Affiliation(s)
- Chittur S Srinivasan
- Department of Food Economics and Marketing, School of Agriculture, Policy and Development, University of Reading, Reading RG6 6AR, UK.
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