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Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach

BACKGROUND: Obesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, h...

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Autores principales: Pujilestari, Cahya Utamie, Nyström, Lennarth, Norberg, Margareta, Weinehall, Lars, Hakimi, Mohammad, Ng, Nawi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727959/
https://www.ncbi.nlm.nih.gov/pubmed/29233136
http://dx.doi.org/10.1186/s12939-017-0708-6
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author Pujilestari, Cahya Utamie
Nyström, Lennarth
Norberg, Margareta
Weinehall, Lars
Hakimi, Mohammad
Ng, Nawi
author_facet Pujilestari, Cahya Utamie
Nyström, Lennarth
Norberg, Margareta
Weinehall, Lars
Hakimi, Mohammad
Ng, Nawi
author_sort Pujilestari, Cahya Utamie
collection PubMed
description BACKGROUND: Obesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, hence requiring different focal points to design public health policies in the latter contexts. We examined socioeconomic inequalities in abdominal obesity in Purworejo District, Central Java, Indonesia and identified factors contributing to the inequalities. METHODS: We utilised data from the WHO-INDEPTH Study on global AGEing and adult health (WHO-INDEPTH SAGE) conducted in the Purworejo Health and Demographic Surveillance System (HDSS) in Purworejo District, Indonesia in 2010. The study included 14,235 individuals aged 50 years and older. Inequalities in abdominal obesity across wealth groups were assessed separately for men and women using concentration indexes. Decomposition analysis was conducted to assess the determinants of socioeconomic inequalities in abdominal obesity. RESULTS: Abdominal obesity was five-fold more prevalent among women than in men (30% vs. 6.1%; p < 0.001). The concentration index (CI) analysis showed that socioeconomic inequalities in abdominal obesity were less prominent among women (CI = 0.26, SE = 0.02, p < 0.001) compared to men (CI = 0.49, SE = 0.04, p < 0.001). Decomposition analysis showed that physical labour was the major determinant of socioeconomic inequalities in abdominal obesity among men, explaining 47% of the inequalities, followed by poor socioeconomic status (31%), ≤ 6 years of education (15%) and current smoking (11%). The three major determinants of socioeconomic inequalities in abdominal obesity among women were poor socio-economic status (48%), physical labour (17%) and no formal education (16%). CONCLUSION: Abdominal obesity was more prevalent among older women in a rural Indonesian setting. Socioeconomic inequality in abdominal obesity exists and concentrates more among the rich population in both sexes. The inequality gap is less prominent among women, indicating a trend towards obesity being more common in poor women. Policies to address social determinants of health need to be developed to address the socioeconomic inequality gaps in obesity, with particular focus on addressing the existing burden of obesity among the better-off population group, while preventing the imminent burden of obesity among the worst-off group, particularly among women.
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spelling pubmed-57279592017-12-18 Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach Pujilestari, Cahya Utamie Nyström, Lennarth Norberg, Margareta Weinehall, Lars Hakimi, Mohammad Ng, Nawi Int J Equity Health Research BACKGROUND: Obesity has become a global health challenge as its prevalence has increased globally in recent decades. Studies in high-income countries have shown that obesity is more prevalent among the poor. In contrast, obesity is more prevalent among the rich in low- and middle-income countries, hence requiring different focal points to design public health policies in the latter contexts. We examined socioeconomic inequalities in abdominal obesity in Purworejo District, Central Java, Indonesia and identified factors contributing to the inequalities. METHODS: We utilised data from the WHO-INDEPTH Study on global AGEing and adult health (WHO-INDEPTH SAGE) conducted in the Purworejo Health and Demographic Surveillance System (HDSS) in Purworejo District, Indonesia in 2010. The study included 14,235 individuals aged 50 years and older. Inequalities in abdominal obesity across wealth groups were assessed separately for men and women using concentration indexes. Decomposition analysis was conducted to assess the determinants of socioeconomic inequalities in abdominal obesity. RESULTS: Abdominal obesity was five-fold more prevalent among women than in men (30% vs. 6.1%; p < 0.001). The concentration index (CI) analysis showed that socioeconomic inequalities in abdominal obesity were less prominent among women (CI = 0.26, SE = 0.02, p < 0.001) compared to men (CI = 0.49, SE = 0.04, p < 0.001). Decomposition analysis showed that physical labour was the major determinant of socioeconomic inequalities in abdominal obesity among men, explaining 47% of the inequalities, followed by poor socioeconomic status (31%), ≤ 6 years of education (15%) and current smoking (11%). The three major determinants of socioeconomic inequalities in abdominal obesity among women were poor socio-economic status (48%), physical labour (17%) and no formal education (16%). CONCLUSION: Abdominal obesity was more prevalent among older women in a rural Indonesian setting. Socioeconomic inequality in abdominal obesity exists and concentrates more among the rich population in both sexes. The inequality gap is less prominent among women, indicating a trend towards obesity being more common in poor women. Policies to address social determinants of health need to be developed to address the socioeconomic inequality gaps in obesity, with particular focus on addressing the existing burden of obesity among the better-off population group, while preventing the imminent burden of obesity among the worst-off group, particularly among women. BioMed Central 2017-12-12 /pmc/articles/PMC5727959/ /pubmed/29233136 http://dx.doi.org/10.1186/s12939-017-0708-6 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Pujilestari, Cahya Utamie
Nyström, Lennarth
Norberg, Margareta
Weinehall, Lars
Hakimi, Mohammad
Ng, Nawi
Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach
title Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach
title_full Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach
title_fullStr Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach
title_full_unstemmed Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach
title_short Socioeconomic inequality in abdominal obesity among older people in Purworejo District, Central Java, Indonesia – a decomposition analysis approach
title_sort socioeconomic inequality in abdominal obesity among older people in purworejo district, central java, indonesia – a decomposition analysis approach
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5727959/
https://www.ncbi.nlm.nih.gov/pubmed/29233136
http://dx.doi.org/10.1186/s12939-017-0708-6
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