1. Are Women’s Empowerment and Income Inequality Associated with Excess Weight in Latin American Cities?
- Author
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Tumas, Natalia, Rodríguez López, Santiago, Mazariegos, Mónica, Ortigoza, Ana, Anza Ramírez, Cecilia, Pérez Ferrer, Carolina, Moore, Kari, Yamada, Goro, Menezes, Mariana Carvalho, Sarmiento, Olga L., Pericàs, Juan M., Belvis Costes, Francesc, Lazo, Mariana, Benach, Joan, Universitat Autònoma de Barcelona, Institut Català de la Salut, [Tumas N] Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain. Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain. Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científcas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina. [Rodríguez López S] Centro de Investigaciones y Estudios sobre Cultura y Sociedad, Consejo Nacional de Investigaciones Científcas y Técnicas (CONICET) y Universidad Nacional de Córdoba, Córdoba, Argentina. Facultad de Ciencias Exactas, Físicas y Naturales, Universidad Nacional de Córdoba, Córdoba, Argentina. [Mazariegos M] INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Guatemala City, Guatemala. [Ortigoza A] Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, USA. [Anza Ramírez C] CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Perú. [Pérez Ferrer C] National Institute of Public Health, Cuernavaca, Mexico. [Pericàs JM] Department of Political and Social Sciences, Research Group on Health Inequalities, Environment, Employment Conditions Knowledge Network (GREDS-EMCONET), Universitat Pompeu Fabra, Barcelona, Spain. Johns Hopkins University - Pompeu Fabra University Public Policy Center (UPF-BSM), Universitat Pompeu Fabra, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Unitat Hepàtica, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain, and Vall d'Hebron Barcelona Hospital Campus
- Subjects
Male ,Health (social science) ,Women’s empowerment ,Dones ,Women's empowerment ,Population Studies in Public Health::Population::Population Characteristics::Residence Characteristics::Urban Area::Cities [PUBLIC HEALTH] ,Ciutats ,Humans ,Obesity ,Other::Other::Female [Other] ,afecciones patológicas, signos y síntomas::signos y síntomas::peso corporal::sobrepeso::obesidad [ENFERMEDADES] ,Income inequality ,Cities ,Public Health, Environmental and Occupational Health ,Pathological Conditions, Signs and Symptoms::Signs and Symptoms::Body Weight::Overweight::Obesity [DISEASES] ,Overweight ,Otros::Otros::femenino [Otros] ,Renda ,Urban Studies ,Latin America ,Estudios Poblacionales en Salud Pública::Población::Características de la Población::características de la residencia::Área urbana::ciudades [SALUD PÚBLICA] ,Obesitat ,Population Characteristics::Socioeconomic Factors::Income [HEALTH CARE] ,Female ,Características de la Población::factores socioeconómicos::renta [ATENCIÓN DE SALUD] - Abstract
While income gradients and gender inequalities in excess weight have been noted elsewhere, data from Latin American cities is lacking. We analyzed gender-specific associations between city-level women’s empowerment and income inequality with individual-level overweight/obesity, assessing how these associations vary by individual education or living conditions within cities in Latin America. Data came from national surveys and censuses, and was compiled by the SALURBAL project (Urban Health in Latin America). The sample included 79,422 individuals (58.0% women), living in 538 sub-cities, 187 cities, and 8 countries. We used gender-stratified Poisson multilevel models to estimate the Prevalence Rate Ratios (PRR) for overweight/obesity (body mass index ≥ 25 kg/m2) per a unit change in city-level women’s empowerment (proxied by a score that measures gender inequalities in employment and education) and income inequality (proxied by income-based Gini coefficient). We also tested whether individual education or sub-city living conditions modified such associations. Higher city labor women’s empowerment (in women) and higher city Gini coefficient (in men) were associated with a lower prevalence of overweight/obesity (PRR = 0.97 (95%CI 0.94, 0.99) and PRR = 0.94 (95%CI 0.90, 0.97), respectively). The associations varied by individual education and sub-city living conditions. For labor women’s empowerment, we observed weakened associations towards the null effect in women with lower education and in residents of sub-cities with worse living conditions (men and women). For the Gini coefficient, the association was stronger among men with primary education, and a negative association was observed in women with primary education. Our findings highlight the need for promoting equity-based policies and interventions to tackle the high prevalence of excess weight in Latin American cities. This work received funding from the European Union’s Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant agreement Nº 89102 (Dr. Tumas was supported by this grant). Joan Benach gratefully acknowledges the financial support by ICREA under the ICREA Academia programme.
- Published
- 2022