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Complex association between rural/urban residence, household wealth and women's overweight: evidence from 30 cross-sectional national household surveys in Africa

Complex association between rural/urban residence, household wealth and women's overweight: evidence from 30 cross-sectional national household surveys in Africa
Complex association between rural/urban residence, household wealth and women's overweight: evidence from 30 cross-sectional national household surveys in Africa

BACKGROUND: We sought to demonstrate that the relationship between urban or rural residence and overweight status among women in Sub-Saharan Africa is complex and confounded by wealth status.

METHODS: We applied multilevel logistic regression to data from 30 sub-Saharan African countries which were collected between 2006 and 2012 to examine the association between women's overweight status (body mass index ≥ 25) and household wealth, rural or urban place of residence, and their interaction. Macro-level statistics from United Nations agencies were used as contextual variables to assess the link between progress in globalization and patterns of overweight.

RESULTS: Household wealth was associated with increased odds of being overweight in nearly all of the countries. Urban/rural living and household wealth had a complex association with women's overweight status, shown by 3 patterns. In one group of countries, characterised by low national wealth (median per capita gross national income (GNI) = $660 in 2012) and lower overall prevalence of female overweight (median = 24 per cent in 2010), high household wealth and urban living had independent associations with increased risks of being overweight. In the second group of less poor countries (median per capita GNI = $870) and higher national levels of female overweight (median = 29), there was a cross-over association where rural women had lower risks of overweight than urban women at lower levels of household wealth, but in wealthier households, rural women had higher risks of overweight than urban women. In the final group of countries, household wealth was an important predictor of overweight status, but the association between urban or rural place of residence and overweight status was not statistically significant. The median per capita GNI for this third group was $800 and national prevalence of female overweight was high (median = 32% in 2010).

CONCLUSIONS: As nations develop and household wealth increases, rural African women are at increased or higher risk of being overweight compared with urban women. Programmes and policies to address rising prevalence of overweight are needed in both rural and urban areas to avoid serious epidemics of non-communicable diseases.

: Sub-Saharan Africa, Overweight, Obesity, Urban/rural residence, Wealth, multilevel
2052-9538
1-12
Madise, Nyovani
2ea2fbcc-50da-4696-a0a5-2fe01db63d8c
Letamo, Gobopamang
1c18f0db-8a4a-48eb-9df5-709df5b0ac61
Madise, Nyovani
2ea2fbcc-50da-4696-a0a5-2fe01db63d8c
Letamo, Gobopamang
1c18f0db-8a4a-48eb-9df5-709df5b0ac61

Madise, Nyovani and Letamo, Gobopamang (2017) Complex association between rural/urban residence, household wealth and women's overweight: evidence from 30 cross-sectional national household surveys in Africa. BMC Obesity, 4 (5), 1-12. (doi:10.1186/s40608-016-0141-1).

Record type: Article

Abstract

BACKGROUND: We sought to demonstrate that the relationship between urban or rural residence and overweight status among women in Sub-Saharan Africa is complex and confounded by wealth status.

METHODS: We applied multilevel logistic regression to data from 30 sub-Saharan African countries which were collected between 2006 and 2012 to examine the association between women's overweight status (body mass index ≥ 25) and household wealth, rural or urban place of residence, and their interaction. Macro-level statistics from United Nations agencies were used as contextual variables to assess the link between progress in globalization and patterns of overweight.

RESULTS: Household wealth was associated with increased odds of being overweight in nearly all of the countries. Urban/rural living and household wealth had a complex association with women's overweight status, shown by 3 patterns. In one group of countries, characterised by low national wealth (median per capita gross national income (GNI) = $660 in 2012) and lower overall prevalence of female overweight (median = 24 per cent in 2010), high household wealth and urban living had independent associations with increased risks of being overweight. In the second group of less poor countries (median per capita GNI = $870) and higher national levels of female overweight (median = 29), there was a cross-over association where rural women had lower risks of overweight than urban women at lower levels of household wealth, but in wealthier households, rural women had higher risks of overweight than urban women. In the final group of countries, household wealth was an important predictor of overweight status, but the association between urban or rural place of residence and overweight status was not statistically significant. The median per capita GNI for this third group was $800 and national prevalence of female overweight was high (median = 32% in 2010).

CONCLUSIONS: As nations develop and household wealth increases, rural African women are at increased or higher risk of being overweight compared with urban women. Programmes and policies to address rising prevalence of overweight are needed in both rural and urban areas to avoid serious epidemics of non-communicable diseases.

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Accepted/In Press date: 19 December 2016
e-pub ahead of print date: 19 January 2017
Published date: 19 January 2017
Keywords: : Sub-Saharan Africa, Overweight, Obesity, Urban/rural residence, Wealth, multilevel
Organisations: Social Statistics & Demography, Southampton Marine & Maritime Institute

Identifiers

Local EPrints ID: 409891
URI: http://eprints.soton.ac.uk/id/eprint/409891
ISSN: 2052-9538
PURE UUID: 5d6ee491-65b6-4a1c-be2e-4722fe6634bf
ORCID for Nyovani Madise: ORCID iD orcid.org/0000-0002-2813-5295

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Date deposited: 01 Jun 2017 04:09
Last modified: 06 Oct 2020 17:23

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