Peng Nie, Lanlin Ding, Alfonso Sousa-Poza, Alina Alfonso Leon, Hong Xue, Peng Jia, Liang Wang, Youfa Wang
{"title":"Inequality of weight status in urban Cuba: 2001-2010.","authors":"Peng Nie, Lanlin Ding, Alfonso Sousa-Poza, Alina Alfonso Leon, Hong Xue, Peng Jia, Liang Wang, Youfa Wang","doi":"10.1186/s12963-021-00251-6","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Although understanding changes in the body weight distribution and trends in obesity inequality plays a key role in assessing the causes and persistence of obesity, limited research on this topic is available for Cuba. This study thus analyzed changes in body mass index (BMI) and waist circumference (WC) distributions and obesity inequality over a 9-year period among urban Cuban adults.</p><p><strong>Methods: </strong>Kolmogorov-Smirnov tests were first applied to the data from the 2001 and 2010 National Survey on Risk Factors and Chronic Diseases to identify a rightward shift in both the BMI and WC distributions over the 2001-2010 period. A Shapley technique decomposed the increase in obesity prevalence into a mean-growth effect and a (re)distributional component. A univariate assessment of obesity inequality was then derived by calculating both the Gini and generalized entropy (GE) measures. Lastly, a GE-based decomposition partitioned overall obesity inequality into within-group and between-group values.</p><p><strong>Results: </strong>Despite some relatively pronounced left-skewing, both the BMI and WC distributions exhibited a clear rightward shift to which the increases in general and central obesity can be mostly attributed. According to the Gini coefficients, both general and central obesity inequality increased over the 2001-2010 period, from 0.105 [95% confidence interval (CI) = 0.103-0.106] to 0.110 [95% CI = 0.107-0.112] and from 0.083 [95% CI = 0.082-0.084] to 0.085 [95% CI = 0.084-0.087], respectively. The GE-based decomposition further revealed that both types of inequality were accounted for primarily by within-group inequality (93.3%/89.6% and 87.5%/84.8% in 2001/2010 for general/central obesity, respectively).</p><p><strong>Conclusions: </strong>Obesity inequality in urban Cuba worsened over the 2001-2010 time period, with within-group inequality in overall obesity dominant over between-group inequality. In general, the results also imply that the rise in obesity inequality is immune to health care system characteristics.</p>","PeriodicalId":51476,"journal":{"name":"Population Health Metrics","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2021-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1186/s12963-021-00251-6","citationCount":"3","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Population Health Metrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12963-021-00251-6","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 3
Abstract
Background: Although understanding changes in the body weight distribution and trends in obesity inequality plays a key role in assessing the causes and persistence of obesity, limited research on this topic is available for Cuba. This study thus analyzed changes in body mass index (BMI) and waist circumference (WC) distributions and obesity inequality over a 9-year period among urban Cuban adults.
Methods: Kolmogorov-Smirnov tests were first applied to the data from the 2001 and 2010 National Survey on Risk Factors and Chronic Diseases to identify a rightward shift in both the BMI and WC distributions over the 2001-2010 period. A Shapley technique decomposed the increase in obesity prevalence into a mean-growth effect and a (re)distributional component. A univariate assessment of obesity inequality was then derived by calculating both the Gini and generalized entropy (GE) measures. Lastly, a GE-based decomposition partitioned overall obesity inequality into within-group and between-group values.
Results: Despite some relatively pronounced left-skewing, both the BMI and WC distributions exhibited a clear rightward shift to which the increases in general and central obesity can be mostly attributed. According to the Gini coefficients, both general and central obesity inequality increased over the 2001-2010 period, from 0.105 [95% confidence interval (CI) = 0.103-0.106] to 0.110 [95% CI = 0.107-0.112] and from 0.083 [95% CI = 0.082-0.084] to 0.085 [95% CI = 0.084-0.087], respectively. The GE-based decomposition further revealed that both types of inequality were accounted for primarily by within-group inequality (93.3%/89.6% and 87.5%/84.8% in 2001/2010 for general/central obesity, respectively).
Conclusions: Obesity inequality in urban Cuba worsened over the 2001-2010 time period, with within-group inequality in overall obesity dominant over between-group inequality. In general, the results also imply that the rise in obesity inequality is immune to health care system characteristics.
背景:虽然了解体重分布的变化和肥胖不平等的趋势在评估肥胖的原因和持久性方面起着关键作用，但古巴对这一主题的研究有限。因此，本研究分析了古巴城市成年人9年来身体质量指数(BMI)和腰围(WC)分布的变化以及肥胖不平等。方法:首先将Kolmogorov-Smirnov检验应用于2001年和2010年全国危险因素和慢性疾病调查的数据，以确定2001-2010年期间BMI和WC分布的右移。Shapley技术将肥胖患病率的增加分解为平均增长效应和(重新)分布成分。然后通过计算基尼系数和广义熵(GE)度量得出肥胖不平等的单变量评估。最后，基于ge的分解将总体肥胖不平等划分为组内和组间值。结果:尽管有一些相对明显的左偏，但BMI和WC分布都表现出明显的右移，这是一般肥胖和中心性肥胖增加的主要原因。根据基尼系数，2001-2010年期间，一般肥胖不平等和中心肥胖不平等均有所增加，分别从0.105[95%可信区间(CI) = 0.103-0.106]增加到0.110 [95% CI = 0.107-0.112]，从0.083 [95% CI = 0.082-0.084]增加到0.085 [95% CI = 0.084-0.087]。基于ge的分解进一步揭示，这两种不平等主要是由群体内不平等造成的(2001/2010年，普通肥胖和中心性肥胖的比例分别为93.3%/89.6%和87.5%/84.8%)。结论:2001-2010年期间，古巴城市肥胖不平等加剧，总体肥胖的组内不平等高于组间不平等。总的来说，研究结果还表明，肥胖不平等的加剧不受医疗保健系统特征的影响。
期刊介绍：
Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
