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The weight of work: the association between maternal employment and overweight in low- and middle-income countries

BACKGROUND: Maternal employment has increased in low-and middle-income countries (LMIC) and is a hypothesized risk factor for maternal overweight due to increased income and behavioral changes related to time allocation. However, few studies have investigated this relationship in LMIC. METHODS: Usin...

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Autores principales: Oddo, Vanessa M., Bleich, Sara N., Pollack, Keshia M., Surkan, Pamela J., Mueller, Noel T., Jones-Smith, Jessica C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389244/
https://www.ncbi.nlm.nih.gov/pubmed/29047365
http://dx.doi.org/10.1186/s12966-017-0522-y
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author Oddo, Vanessa M.
Bleich, Sara N.
Pollack, Keshia M.
Surkan, Pamela J.
Mueller, Noel T.
Jones-Smith, Jessica C.
author_facet Oddo, Vanessa M.
Bleich, Sara N.
Pollack, Keshia M.
Surkan, Pamela J.
Mueller, Noel T.
Jones-Smith, Jessica C.
author_sort Oddo, Vanessa M.
collection PubMed
description BACKGROUND: Maternal employment has increased in low-and middle-income countries (LMIC) and is a hypothesized risk factor for maternal overweight due to increased income and behavioral changes related to time allocation. However, few studies have investigated this relationship in LMIC. METHODS: Using cross-sectional samples from Demographic and Health Surveys, we investigated the association between maternal employment and overweight (body mass index [BMI] ≥ 25 kg/m(2)) among women in 38 LMIC (N = 162,768). We categorized mothers as formally employed, informally employed, or non-employed based on 4 indicators: employment status in the last 12 months; aggregate occupation category (skilled, unskilled); type of earnings (cash only, cash and in-kind, in-kind only, unpaid); and seasonality of employment (all year, seasonal/occasional employment). Formally employed women were largely employed year-round in skilled occupations and earned a wage (e.g. professional), whereas informally employed women were often irregularly employed in unskilled occupations and in some cases, were paid in-kind (e.g. domestic work). For within-country analyses, we used adjusted logistic regression models and included an interaction term to assess heterogeneity in the association by maternal education level. We then used meta-analysis and meta-regression to explore differences in the associations pooled across countries. RESULTS: Compared to non-employed mothers, formally employed mothers had higher odds of overweight (pooled odds ratio [POR] = 1.3; 95% Confidence Interval [CI] 1.2, 1.4) whereas informally employed mothers, compared to non-employed mothers, had lower odds of overweight (POR = 0.72; 95% CI: 0.64, 0.81). In 14 LMIC, the association varied by education. In these countries, the magnitude of the formal employment-overweight association was larger for women with low education (POR = 1.5; 95% CI: 1.1, 1.9) compared to those with high education (POR = 1.2; 95% CI: 1.0, 1.3). CONCLUSIONS: Formally employed mothers in LMIC have higher odds of overweight and the association varies by educational attainment in 14 countries. This knowledge highlights the importance of workplace initiatives to reduce the risk of overweight among working women in LMIC. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12966-017-0522-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-63892442019-03-19 The weight of work: the association between maternal employment and overweight in low- and middle-income countries Oddo, Vanessa M. Bleich, Sara N. Pollack, Keshia M. Surkan, Pamela J. Mueller, Noel T. Jones-Smith, Jessica C. Int J Behav Nutr Phys Act Research BACKGROUND: Maternal employment has increased in low-and middle-income countries (LMIC) and is a hypothesized risk factor for maternal overweight due to increased income and behavioral changes related to time allocation. However, few studies have investigated this relationship in LMIC. METHODS: Using cross-sectional samples from Demographic and Health Surveys, we investigated the association between maternal employment and overweight (body mass index [BMI] ≥ 25 kg/m(2)) among women in 38 LMIC (N = 162,768). We categorized mothers as formally employed, informally employed, or non-employed based on 4 indicators: employment status in the last 12 months; aggregate occupation category (skilled, unskilled); type of earnings (cash only, cash and in-kind, in-kind only, unpaid); and seasonality of employment (all year, seasonal/occasional employment). Formally employed women were largely employed year-round in skilled occupations and earned a wage (e.g. professional), whereas informally employed women were often irregularly employed in unskilled occupations and in some cases, were paid in-kind (e.g. domestic work). For within-country analyses, we used adjusted logistic regression models and included an interaction term to assess heterogeneity in the association by maternal education level. We then used meta-analysis and meta-regression to explore differences in the associations pooled across countries. RESULTS: Compared to non-employed mothers, formally employed mothers had higher odds of overweight (pooled odds ratio [POR] = 1.3; 95% Confidence Interval [CI] 1.2, 1.4) whereas informally employed mothers, compared to non-employed mothers, had lower odds of overweight (POR = 0.72; 95% CI: 0.64, 0.81). In 14 LMIC, the association varied by education. In these countries, the magnitude of the formal employment-overweight association was larger for women with low education (POR = 1.5; 95% CI: 1.1, 1.9) compared to those with high education (POR = 1.2; 95% CI: 1.0, 1.3). CONCLUSIONS: Formally employed mothers in LMIC have higher odds of overweight and the association varies by educational attainment in 14 countries. This knowledge highlights the importance of workplace initiatives to reduce the risk of overweight among working women in LMIC. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12966-017-0522-y) contains supplementary material, which is available to authorized users. BioMed Central 2017-10-18 /pmc/articles/PMC6389244/ /pubmed/29047365 http://dx.doi.org/10.1186/s12966-017-0522-y 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
Oddo, Vanessa M.
Bleich, Sara N.
Pollack, Keshia M.
Surkan, Pamela J.
Mueller, Noel T.
Jones-Smith, Jessica C.
The weight of work: the association between maternal employment and overweight in low- and middle-income countries
title The weight of work: the association between maternal employment and overweight in low- and middle-income countries
title_full The weight of work: the association between maternal employment and overweight in low- and middle-income countries
title_fullStr The weight of work: the association between maternal employment and overweight in low- and middle-income countries
title_full_unstemmed The weight of work: the association between maternal employment and overweight in low- and middle-income countries
title_short The weight of work: the association between maternal employment and overweight in low- and middle-income countries
title_sort weight of work: the association between maternal employment and overweight in low- and middle-income countries
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389244/
https://www.ncbi.nlm.nih.gov/pubmed/29047365
http://dx.doi.org/10.1186/s12966-017-0522-y
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