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      Factors associated with body mass index among slum dwelling women in India: an analysis of the 2005–2006 Indian National Family Health Survey

      research-article
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      International Journal of General Medicine
      Dove Medical Press
      slums, India, BMI, women, caste, obesity, poverty

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          Abstract

          Background

          Urbanization is increasing around the world, and in India, this trend has translated into an increase in the size of slum dwellings whose environments are suspected of being associated with poor health outcomes, particularly those relating to women’s nutritional status. With this study, we sought to determine the factors associated with Indian women’s body mass index (BMI) in slum environments, with special attention paid to women with tribal status.

          Methods

          A multiple linear regression analysis was performed on data from the Indian National Family Health Survey (2005–2006), modeling demographic and behavioral factors suspected of being associated with BMI, with additional focus on the measures of social class, specifically caste and tribal status.

          Results

          Increasing BMI is significantly and positively associated with frequency of watching television, having diabetes, age, wealth index, and residency status in the areas of New Delhi, Andhra Pradesh, or Tamil Nadu.

          Conclusion

          Although belonging to a scheduled tribe was not associated with changes in BMI, unadjusted rates suggest that tribal status may be worthy of deeper investigation. Among slum dwellers, there is a double burden of undernutrition and overnutrition. Therefore, a diverse set of interventions may be required to improve the health outcomes of these women.

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          Most cited references14

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          Changing patterns of diet, physical activity and obesity among urban, rural and slum populations in north India.

          Rapid urbanization and accompanying lifestyle changes in India lead to transition in non-communicable disease risk factors. A survey was done in urban, urban slum and rural population of Haryana, India, in a sample of 4129 men and 3852 women using WHO STEPS questionnaire. A very high proportion of all the three populations reported inadequate intake of fruits and vegetables. Rural men reported five times physical activity as compared with urban and urban slum men and rural women reported seven times physical activity as compared with women in the other two settings. Mean body mass index (BMI) was highest among urban men (22.8 kg m(-2)) followed by urban slum (21.0 kg m(-2)) and rural men (20.6 kg m(-2)) (P-value /= 30 kg m(-2)) was highest for urban population (male = 5.5%, female = 12.6%) followed by urban slum (male = 1.9%, female = 7.2%) and rural populations (male = 1.6%, female = 3.8%). Urbanization increases the prevalence of the studied non-communicable disease risk factors, with women showing a greater increase as compared with men. Non-communicable disease control strategy needs to address urbanization and warrants gender sensitive strategies specifically targeting women.
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            Is obesity becoming a public health problem in India? Examine the shift from under- to overnutrition problems over time.

            This study aimed to examine the prevalence and trends of overweight, obesity and undernutrition in recent decades in India. Based on a systematic literature search on PubMed and other data sources, most published studies were regional or local surveys in urban areas, while good representative data from the India National Family Health Surveys (NFHS, 1992-1993, 1998-1999 and 2005-2006) allowed for examining the trends at the national level. Overall, the available data showed that in India, prevalence of overweight was low while that of undernutrition remained high. Overweight was more prevalent among female, urban and high-socioeconomic-status (SES) groups. NFHS data showed that the prevalence of overweight in women and pre-school children did not increase much in the last decade: 10.6% and 1.6% in 1998-1999 to 12.6% and 1.5% in 2005-2006 respectively. As for underweight, NFHS 2005-2006 showed high prevalence among ever-married women (about 35%) and pre-school children (about 42%). The prevalence of overweight and obesity had increased slightly over the past decade in India, but in some urban and high-SES groups it reached a relatively high level. Factors associated with undernutrition need closer examination, and prevention of obesity should be targeted at the high-risk groups simultaneously.
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              Off the map: the health and social implications of being a non-notified slum in India.

              Approximately half of all slums in India are not recognized by the government. Lack of government recognition, also referred to as "non-notified status" in the Indian context, may create entrenched barriers to legal rights and basic services such as water, sanitation, and security of tenure. In this paper, we explore the relationship between non-notified status and health outcomes in Kaula Bandar (KB), a slum in Mumbai, India. We illuminate this relationship using the findings of a four-year series of studies in the community. By comparing KB's statistics to those from other Mumbai slums captured by India's National Family Health Survey-3, we show that KB has relative deficiencies in several health and social outcomes, including those for educational status, child health, and adult nutrition. We then provide an explanatory framework for the role that KB's non-notified status may play in generating poor health outcomes by discussing the health consequences of the absence of basic services and the criminalization of activities required to fulfill fundamental needs such as water access, toileting, and shelter. We argue that the policy vacuum surrounding non-notified slums like KB results in governance failures that lead to poor health outcomes. Our findings highlight the need for cities in India and other developing countries to establish and fulfill minimum humanitarian standards in non-notified slums for the provision of basic services such as water, sanitation, solid waste removal, electricity, and education.
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                Author and article information

                Journal
                Int J Gen Med
                Int J Gen Med
                International Journal of General Medicine
                International Journal of General Medicine
                Dove Medical Press
                1178-7074
                2017
                07 February 2017
                : 10
                : 27-31
                Affiliations
                Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
                Author notes
                Correspondence: Raywat Deonandan, Interdisciplinary School of Health Sciences, University of Ottawa, Thomson Hall, 25 University Private, Ottawa, ON, Canada K1N 6N5, Tel +1 613 562 5800ext8377, Email ray@ 123456deonandan.com
                Article
                ijgm-10-027
                10.2147/IJGM.S82912
                5304981
                f7ac7735-8ff5-4f38-b3ff-47cf9906cdf6
                © 2017 Patel and Deonandan. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Original Research

                Medicine
                slums,india,bmi,women,caste,obesity,poverty
                Medicine
                slums, india, bmi, women, caste, obesity, poverty

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