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Agnihotri A, Viswanathan B. Variations in adult BMI among Indian men: a quantile regression analysis. J Biosoc Sci 2024; 56:251-269. [PMID: 37814949 DOI: 10.1017/s0021932023000202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Abstract
India has not only maintained its top position among countries with the largest number of underweight adults but has also jumped to a higher position among countries with largest increase in the proportion of overweight people in the last three decades. More studies focus on double burden of malnutrition among women than on men. This study uses the quantile regression model to analyse the covariates associated with low and high body mass index (BMI) primarily among men aged 20-54 years during 2015-2016 in India. Occupations that involve more manual work help in maintaining a normal BMI along with better education, dietary diversity, and less sedentary lifestyle. A gendered comparison of men and their spouses highlights the differences in the association of covariates with BMI for men and women. The results from this study will provide insights for behavioural change at an individual level and inputs for public health intervention for addressing ill health concerns arising from underweight, overweight, or obesity.
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Martin-Bassols N, de New SC, Johnston DW, Shields MA. Cognitive activity at work and the risk of dementia. Health Econ 2023; 32:1561-1580. [PMID: 36967557 DOI: 10.1002/hec.4679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 02/27/2023] [Accepted: 03/03/2023] [Indexed: 06/04/2023]
Abstract
Dementia prevalence is projected to rise steeply in coming decades, producing tremendous burdens on families, and health and social services. Motivated by the need for further robust evidence on modifiable risk factors, we investigate the relationship between cognitive activity at work and later-life dementia. Using data from the US Health and Retirement Study matched to the O*NET occupational database, we find that a one standard deviation increase in the cognitive activity associated with one's longest held occupation is associated with a 0.9 percentage point reduction in (predicted) dementia, or a 24% reduction relative to the mean. This relationship is consistently found across model specifications and robustness tests. When controlling for individual fixed-effects we find that the association between dementia and work cognitive activity increases with age. Overall, our results provide some evidence in support of the inclusion of cognitive activity at work as a recognized modifiable risk factor for dementia.
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Affiliation(s)
| | - Sonja C de New
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia
| | - David W Johnston
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia
| | - Michael A Shields
- Centre for Health Economics, Monash University, Clayton, Victoria, Australia
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Okunogbe A, Nugent R, Spencer G, Powis J, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for 161 countries. BMJ Glob Health 2022; 7:e009773. [PMID: 36130777 PMCID: PMC9494015 DOI: 10.1136/bmjgh-2022-009773] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/13/2022] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The scope of the challenge of overweight and obesity (OAO) has not been fully realised globally, in part because much of what is known about the economic impacts of OAO come from high-income countries (HICs) and are not readily comparable due to methodological differences. Our objective is to estimate the current and future national economic impacts of OAO globally. METHODS We estimated economic impacts of OAO for 161 countries using a cost-of-illness approach. Direct and indirect costs of OAO between 2019 and 2060 were estimated from a societal perspective. We assessed the effect of two hypothetical scenarios of OAO prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS The economic impact of OAO in 2019 is estimated at 2.19% of global gross domestic product (GDP) ranging on average from US$20 per capita in Africa to US$872 per capita in the Americas and from US$6 in low-income countries to US$1110 in HICs.If current trends continue, by 2060, the economic impacts from OAO are projected to rise to 3.29% of GDP globally. The biggest increase will be concentrated in lower resource countries with total economic costs increasing by fourfold between 2019 and 2060 in HICs, whereas they increase 12-25 times in low and middle-income countries. Reducing projected OAO prevalence by 5% annually from current trends or keeping it at 2019 levels will translate into average annual reductions of US$429 billion or US$2201 billion in costs, respectively, between 2020 and 2060 globally. CONCLUSION This study provides novel evidence on the economic impact of OAO across different economic and geographic contexts. Our findings highlight the need for concerted and holistic action to address the global rise in OAO prevalence, to avert the significant risks of inaction and achieve the promise of whole-of-society gains in population well-being.
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Affiliation(s)
| | - Rachel Nugent
- Center for GlobalNoncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Garrison Spencer
- Center for GlobalNoncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
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Li P, Chen X, Stafford F, Ou J. Body shape and stable employment opportunity analysis of China's nonagricultural labor market. SSM Popul Health 2022; 17:101014. [PMID: 35024421 PMCID: PMC8733337 DOI: 10.1016/j.ssmph.2021.101014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/11/2021] [Accepted: 12/20/2021] [Indexed: 10/31/2022] Open
Abstract
Based on the integrated data of the China General Social Survey (CGSS) from 2010 to 2017, this study observes that body shape - being overweight or underweight - is important for labor market outcomes. Body shape significantly affects the employment opportunities of Chinese individuals, and this effect differs by gender and across the occupational hierarchy. Women face both slim premium and obesity penalty effects. Slim women, those with normal and lower but not excessively lower body weight, are more likely to gain long-term employment contracts in the labor market, while the opposite is observed for overweight individuals. The relationship between women's body shape and employment opportunities also varies by occupation. The obesity penalty is more pronounced in occupations with a higher International Socio-Economic Index (ISEI), while the slim premium is more evident in occupations with a low ISEI. The results suggest that the Chinese labor market is highly demanding regarding women's figures, while it is relatively tolerant of men's figures. By mechanism analysis, health capital is found to be the leading cause of the body shape effect. In addition, socialization is also a possible pathway of action. This paper has extended implications for the study of stature and employment stability, enriching the empirical research on labor market discrimination.
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Affiliation(s)
- Ping Li
- Associate Professor of Economics, School of Economics and Management, South China Normal University, Guangzhou, 510006, China
| | - Xiaozhou Chen
- Associate Professor of Economics, School of Business Administration, Guangdong University of Finance, Guangzhou, 510006, China
| | - Frank Stafford
- Professor of Economics, Department of Economics and Institute for Social Research, University of Michigan, Ann arbor, Michigan, 48108, United States
| | - Jinyun Ou
- Ph.D. Candidate, School of Economics and Management, South China Normal University, Guangzhou, 510006, China
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Aiyar A, Dhingra S, Pingali P. Transitioning to an obese India: Demographic and structural determinants of the rapid rise in overweight incidence. Econ Hum Biol 2021; 43:101041. [PMID: 34332246 DOI: 10.1016/j.ehb.2021.101041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 06/29/2021] [Accepted: 07/02/2021] [Indexed: 06/13/2023]
Abstract
India, which has long suffered from undernutrition, has seen a rapid rise in overweight incidence in the last decade and a half. These changes are characterized by significant within-country differences in overweight incidence that vary by gender and regional development levels. In this paper, we provide an integrative framework, linking the income-gradient hypothesis of obesity with biological, obesogenic, and environmental factors to provide an explanation on the emergence of within-country differences in overweight patterns. We utilize measured body mass index (BMI), along with individual- and household-level data of over 800,000 men and women surveyed in the National Family Health Surveys of 2005-06 and 2015-16 to identify correlates of within-country differences in overweight incidence. A decomposition analysis reveals that among women, in addition to increasing access to obesogenic technologies, biological factors are associated with overweight incidence. Among men, obesogenic factors related to technology use and health behaviors are associated with the rise in overweight incidence, but biological factors are not. At lower levels of regional development, overweight incidence is associated with greater access to obesogenic technology such as motorized transport, which reduces physical activity among men at higher rates than women. At higher levels of economic development, obesogenic behaviors, such as watching more television and reducing smoking, are associated with overweight incidence. Our results corroborate the call by public health experts for group-specific policies to stem the rise of overweight incidence in developing countries.
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Affiliation(s)
- Anaka Aiyar
- Department of Economics, University of Nevada, Reno, 1664 N Virginia Avenue, Reno, NV, 89557, United States.
| | - Sunaina Dhingra
- School of Government and Public Policy, O P Jindal Global University, Sonipat, Haryana, 131001, India.
| | - Prabhu Pingali
- Tata-Cornell Institute for Agriculture and Nutrition, Charles H. Dyson School of Applied Economics and Management, Cornell University, 375 Warren Hall, Ithaca, NY, 14853, United States.
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Okunogbe A, Nugent R, Spencer G, Ralston J, Wilding J. Economic impacts of overweight and obesity: current and future estimates for eight countries. BMJ Glob Health 2021; 6:e006351. [PMID: 34737167 PMCID: PMC8487190 DOI: 10.1136/bmjgh-2021-006351] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 08/29/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Obesity is a growing public health challenge worldwide with significant health and economic impacts. However, much of what is known about the economic impacts of obesity comes from high-income countries and studies are not readily comparable due to methodological differences. Our objective is to demonstrate a method for estimating current and future national economic impacts of obesity and apply it across a sample of heterogeneous contexts globally. METHODS We estimated economic impacts of overweight and obesity for eight countries using a cost-of-illness approach. Direct and indirect costs of obesity from 2019 to 2060 were estimated from a societal perspective as well as the effect of two hypothetical scenarios of obesity prevalence projections. Country-specific data were sourced from published studies and global databases. RESULTS In per capita terms, costs of obesity in 2019 ranged from US$17 in India to US$940 in Australia. These economic costs are comparable to 1.8% of gross domestic product (GDP) on average across the eight countries, ranging from 0.8% of GDP in India to 2.4% in Saudi Arabia. By 2060, with no significant changes to the status quo, the economic impacts from obesity are projected to grow to 3.6% of GDP on average ranging from 2.4% of GDP in Spain to 4.9% of GDP in Thailand. Reducing obesity prevalence by 5% from projected levels or keeping it at 2019 levels will translate into an average annual reduction of 5.2% and 13.2% in economic costs, respectively, between 2020 and 2060 across the eight countries. CONCLUSION Our findings demonstrate that the economic impacts of obesity are substantial across countries, irrespective of economic or geographical context and will increase over time if current trends continue. These findings strongly point to the need for advocacy to increase awareness of the societal impacts of obesity, and for policy actions to address the systemic roots of obesity.
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Affiliation(s)
| | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Seattle, Washington, USA
| | - Garrison Spencer
- Center for Global Noncommunicable Diseases, RTI International, Seattle, Washington, USA
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Li P, Chen X, Yao Q. Body Mass and Income: Gender and Occupational Differences. Int J Environ Res Public Health 2021; 18:ijerph18189599. [PMID: 34574522 PMCID: PMC8468324 DOI: 10.3390/ijerph18189599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
This paper aims to examine the influence of body shape on income, which varies with gender and occupational structure in China. The data were obtained from the CGSS (Chinese General Social Survey) 2010-2017 Survey. The overall finding in this paper is that women and men face different body shape-income effects. For females, the obesity penalty is significant and is reinforced with increasing occupational rank. For men, the thinness penalty (or weight premium) is enhanced as the occupational class decreases. Body shape-income gaps are mainly caused by the occupational structure. Twenty-nine percent of the income gap between overweight and average weight women can be explained by the obesity penalty, 37% of the income gap between overweight and average weight men can be interpreted by the weight premium, and 11% of the gap between underweight and normal weight men can be explained by the thinness penalty. The findings also suggest that the effect of body shape on income consists of two pathways: body shape affects health capital and socialization, and therefore income. Healthy lifestyles and scientific employment concepts should be promoted, and measures to close the gender gap should be implemented.
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Affiliation(s)
- Ping Li
- School of Economics and Management, South China Normal University, Guangzhou 510006, China; (P.L.); (Q.Y.)
| | - Xiaozhou Chen
- School of Business Administration, Guangdong University of Finance, Guangzhou 510521, China
- Correspondence:
| | - Qi Yao
- School of Economics and Management, South China Normal University, Guangzhou 510006, China; (P.L.); (Q.Y.)
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Menon N. Does BMI predict the early spatial variation and intensity of Covid-19 in developing countries? Evidence from India. Econ Hum Biol 2021; 41:100990. [PMID: 33631439 PMCID: PMC7886627 DOI: 10.1016/j.ehb.2021.100990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 02/07/2021] [Accepted: 02/11/2021] [Indexed: 06/12/2023]
Abstract
This paper studies BMI as a correlate of the early spatial distribution and intensity of Covid-19 across the districts of India and finds that conditional on a range of individual, household and regional characteristics, adult BMI significantly predicts the likelihood that the district is a hotspot, the natural log of the confirmed number of cases, the case fatality rate, and the propensity that the district is a red zone. Controlling for air-pollution, rainfall, temperature, demographic factors that measure population density, the proportion of the elderly, and health infrastructure including per capita health spending and the proportion of respiratory cases, does not diminish the predictive power of BMI in influencing the spatial incidence and spread of the virus. The association between adult BMI and measures of spatial outcomes is especially pronounced among educated populations in urban settings, and impervious to conditioning on differences in testing rates across states. We find that among women, BMI proxies for a range of comorbidities (hemoglobin, high blood pressure and high glucose levels) that affects the severity of the virus while among men, these health indicators are also important, as is exposure to risk of contracting the virus as measured by work propensities. We conduct sensitivity checks and control for differences that may arise due to variations in timing of onset. Our results provide a readily available health marker that may be used to identify and protect especially at-risk populations in developing countries like India.
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Affiliation(s)
- Nidhiya Menon
- Department of Economics, MS 021, Brandeis University, Waltham, MA 02453, USA.
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