Measuring and Decomposing Socioeconomic Inequalities in Adult Obesity in Western Iran

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Abstract

Objectives

Obesity is a considerable and growing public health concern worldwide. The present study aimed to quantify socioeconomic inequalities in adult obesity in western Iran.

Methods

A total of 10 086 participants, aged 35-65 years, from the Ravansar Non-communicable Disease Cohort Study (2014-2016) were included in the study to examine socioeconomic inequalities in obesity. We defined obesity as a body mass index ≥30 kg/m ². The concentration index and concentration curve were used to illustrate and measure wealth-related inequality in obesity. Additionally, we decomposed the concentration index to identify factors that explained wealth-related inequality in obesity.

Results

Overall, the prevalence of obesity in the total sample was 26.7%. The concentration index of obesity was 0.04; indicating that obesity was more concentrated among the rich ( p<0.001). Decomposition analysis indicated that wealth, place of residence, and marital status were the main contributors to the observed inequality in obesity.

Conclusions

Socioeconomic-related inequalities in obesity among adults warrant more attention. Policies should be designed to reduce both the prevalence of obesity and inequalities in obesity by focusing on those with higher socioeconomic status, urban residents, and married individuals.

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Most cited references 31

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Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Marie Ng, Tom Fleming, Margaret W. Robinson … (2015)

In 2010, overweight and obesity were estimated to cause 3·4 million deaths, 3·9% of years of life lost, and 3·8% of disability-adjusted life-years (DALYs) worldwide. The rise in obesity has led to widespread calls for regular monitoring of changes in overweight and obesity prevalence in all populations. Comparable, up-to-date information about levels and trends is essential to quantify population health effects and to prompt decision makers to prioritise action. We estimate the global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013. We systematically identified surveys, reports, and published studies (n=1769) that included data for height and weight, both through physical measurements and self-reports. We used mixed effects linear regression to correct for bias in self-reports. We obtained data for prevalence of obesity and overweight by age, sex, country, and year (n=19,244) with a spatiotemporal Gaussian process regression model to estimate prevalence with 95% uncertainty intervals (UIs). Worldwide, the proportion of adults with a body-mass index (BMI) of 25 kg/m(2) or greater increased between 1980 and 2013 from 28·8% (95% UI 28·4-29·3) to 36·9% (36·3-37·4) in men, and from 29·8% (29·3-30·2) to 38·0% (37·5-38·5) in women. Prevalence has increased substantially in children and adolescents in developed countries; 23·8% (22·9-24·7) of boys and 22·6% (21·7-23·6) of girls were overweight or obese in 2013. The prevalence of overweight and obesity has also increased in children and adolescents in developing countries, from 8·1% (7·7-8·6) to 12·9% (12·3-13·5) in 2013 for boys and from 8·4% (8·1-8·8) to 13·4% (13·0-13·9) in girls. In adults, estimated prevalence of obesity exceeded 50% in men in Tonga and in women in Kuwait, Kiribati, Federated States of Micronesia, Libya, Qatar, Tonga, and Samoa. Since 2006, the increase in adult obesity in developed countries has slowed down. Because of the established health risks and substantial increases in prevalence, obesity has become a major global health challenge. Not only is obesity increasing, but no national success stories have been reported in the past 33 years. Urgent global action and leadership is needed to help countries to more effectively intervene. Bill & Melinda Gates Foundation. Copyright © 2014 Elsevier Ltd. All rights reserved.

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Prospective Epidemiological Research Studies in Iran (the PERSIAN Cohort Study): Rationale, Objectives, and Design.

Hossein Poustchi, Sareh Eghtesad, Farin Kamangar … (2018)

Noncommunicable diseases (NCDs) account for 76% of deaths in Iran, and this number is on the rise, in parallel with global rates. Many risk factors associated with NCDs are preventable; however, it is first necessary to conduct observational studies to identify relevant risk factors and the most appropriate approach to controlling them. Iran is a multiethnic country; therefore, in 2014 the Ministry of Health and Medical Education launched a nationwide cohort study-Prospective Epidemiological Research Studies in Iran (PERSIAN)-in order to identify the most prevalent NCDs among Iran's ethnic groups and to investigate effective methods of prevention. The PERSIAN study consists of 4 population-based cohorts; the adult component (the PERSIAN Cohort Study), described in this article, is a prospective cohort study including 180,000 persons aged 35-70 years from 18 distinct areas of Iran. Upon joining the cohort, participants respond to interviewer-administered questionnaires. Blood, urine, hair, and nail samples are collected and stored. To ensure consistency, centrally purchased equipment is sent to all sites, and the same team trains all personnel. Routine visits and quality assurance/control measures are taken to ensure protocol adherence. Participants are followed for 15 years postenrollment. The PERSIAN study is currently in the enrollment phase; cohort profiles will soon emerge.

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The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality.

Adam Wagstaff (2005)

When the health sector variable whose inequality is being investigated is binary, the minimum and maximum possible values of the concentration index are equal to micro-1 and 1-micro, respectively, where micro is the mean of the variable in question. Thus as the mean increases, the range of the possible values of the concentration index shrinks, tending to zero as the mean tends to one and the concentration index tends to zero. Examples are presented on levels of and inequalities in immunization across 41 developing countries, and on changes in coverage and inequalities in selected countries. Copyright (c) 2004 John Wiley & Sons, Ltd.

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Author and article information

Journal

Journal ID (nlm-ta): J Prev Med Public Health

Journal ID (iso-abbrev): J Prev Med Public Health

Journal ID (publisher-id): JPMPH

Title: Journal of Preventive Medicine and Public Health

Publisher: Korean Society for Preventive Medicine

ISSN (Print): 1975-8375

ISSN (Electronic): 2233-4521

Publication date (Print): November 2018

Publication date (Electronic): 29 October 2018

Volume: 51

Issue: 6

Pages: 289-297

Affiliations

[1 ]Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran

[2 ]Department of Nutrition, Faculty of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran

Author notes

Corresponding author: Moslem Soofi, PhD Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah 67198-51351, Iran E-mail: moslemsoofi@ 123456yahoo.com

Author information

Farid Najafi http://orcid.org/0000-0002-0534-6444

Yahya Pasdar http://orcid.org/0000-0001-8682-5721

Behrooz Hamzeh http://orcid.org/0000-0002-1110-0870

Satar Rezaei http://orcid.org/0000-0002-6194-6057

Mehdi Moradi Nazar http://orcid.org/0000-0001-7033-6755

Moslem Soofi http://orcid.org/0000-0003-4922-8412

Article

Publisher ID: jpmph-51-6-289

DOI: 10.3961/jpmph.18.062

PMC ID: 6283744

PubMed ID: 30514059

SO-VID: 22f0a41f-ee1a-4e47-af70-637ab7b24f5a

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Measuring and Decomposing Socioeconomic Inequalities in Adult Obesity in Western Iran

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Abstract

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Karger: Nutrition and Dietetics

Most cited references 31

Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013.

Prospective Epidemiological Research Studies in Iran (the PERSIAN Cohort Study): Rationale, Objectives, and Design.

The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality.

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