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Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan
BACKGROUND: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with und...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383475/ https://www.ncbi.nlm.nih.gov/pubmed/25835540 http://dx.doi.org/10.1371/journal.pone.0122314 |
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author | Janjua, Naveed Zafar Mahmood, Bushra Bhatti, Junaid A. Khan, M. Imran |
author_facet | Janjua, Naveed Zafar Mahmood, Bushra Bhatti, Junaid A. Khan, M. Imran |
author_sort | Janjua, Naveed Zafar |
collection | PubMed |
description | BACKGROUND: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with under- and over-weight categories of BMI among Pakistani women. METHODS: We analyzed data on 4,767 women ages 15-49 years enrolled in a nationally representative Pakistan Demographic Health Survey (PDHS) conducted in 2012-13 that employed a multistage, stratified cluster sampling design. We assessed the association of urbanicity, household and community SEP derived from household assets and utilities, with categories of body mass index (BMI) using multinomial regression analysis where normal weight (BMI 18.6-22.5) was the reference category. RESULTS: Thirteen percent of women were underweight (BMI <18.5), 15% pre-overweight (BMI: 22.6-24.9), 25% overweight (BMI: 25.0–29.9) and 14% were obese (BMI≥30). Pre-overweight, overweight and obesity among women increased across household wealth quintiles (HWQs) in a graded fashion whereas there was no significant difference in underweight by household wealth. Women in urban areas were more likely to be obese. There was a pronounced increase in adjusted odds ratios (aORs) for overweight/obesity across HWQs within urban areas compared to rural areas. There was a steeper gradient in aORs for obesity from 1st to 5th HWQs in high income communities compared to the middle- and low income communities. In community-level analyses, communities in urban areas were more likely to have higher levels of obesity while in rural areas, especially in Sindh, more communities were more likely to have a higher level of underweight. CONCLUSION: A shift to higher overweight and obesity than underweight in Pakistan is associated with high household and community wealth as well as living in urban areas. Clustering of obesity and underweight in distinct communities afford opportunity for tailored intervention programs. |
format | Online Article Text |
id | pubmed-4383475 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-43834752015-04-09 Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan Janjua, Naveed Zafar Mahmood, Bushra Bhatti, Junaid A. Khan, M. Imran PLoS One Research Article BACKGROUND: Similar to other developing countries, Pakistan is going through a rapid nutrition transition where shift from underweight to overweight and obesity is occurring. In this paper, we report on the relationship of household socioeconomic position (SEP), community SEP and urbanicity with under- and over-weight categories of BMI among Pakistani women. METHODS: We analyzed data on 4,767 women ages 15-49 years enrolled in a nationally representative Pakistan Demographic Health Survey (PDHS) conducted in 2012-13 that employed a multistage, stratified cluster sampling design. We assessed the association of urbanicity, household and community SEP derived from household assets and utilities, with categories of body mass index (BMI) using multinomial regression analysis where normal weight (BMI 18.6-22.5) was the reference category. RESULTS: Thirteen percent of women were underweight (BMI <18.5), 15% pre-overweight (BMI: 22.6-24.9), 25% overweight (BMI: 25.0–29.9) and 14% were obese (BMI≥30). Pre-overweight, overweight and obesity among women increased across household wealth quintiles (HWQs) in a graded fashion whereas there was no significant difference in underweight by household wealth. Women in urban areas were more likely to be obese. There was a pronounced increase in adjusted odds ratios (aORs) for overweight/obesity across HWQs within urban areas compared to rural areas. There was a steeper gradient in aORs for obesity from 1st to 5th HWQs in high income communities compared to the middle- and low income communities. In community-level analyses, communities in urban areas were more likely to have higher levels of obesity while in rural areas, especially in Sindh, more communities were more likely to have a higher level of underweight. CONCLUSION: A shift to higher overweight and obesity than underweight in Pakistan is associated with high household and community wealth as well as living in urban areas. Clustering of obesity and underweight in distinct communities afford opportunity for tailored intervention programs. Public Library of Science 2015-04-02 /pmc/articles/PMC4383475/ /pubmed/25835540 http://dx.doi.org/10.1371/journal.pone.0122314 Text en © 2015 Janjua et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Janjua, Naveed Zafar Mahmood, Bushra Bhatti, Junaid A. Khan, M. Imran Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan |
title | Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan |
title_full | Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan |
title_fullStr | Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan |
title_full_unstemmed | Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan |
title_short | Association of Household and Community Socioeconomic Position and Urbanicity with Underweight and Overweight among Women in Pakistan |
title_sort | association of household and community socioeconomic position and urbanicity with underweight and overweight among women in pakistan |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4383475/ https://www.ncbi.nlm.nih.gov/pubmed/25835540 http://dx.doi.org/10.1371/journal.pone.0122314 |
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