TY - JOUR
T1 - The gradual shift of overweight, obesity, and abdominal obesity towards the poor in a multi-ethnic developing country
T2 - Findings from the Malaysian national health and morbidity surveys
AU - Mariapun, Jeevitha
AU - Ng, Chiu Wan
AU - Hairi, Noran N.
N1 - Funding Information:
It is acknowledged that this study is supported by the University of Malaya=Ministry of Higher Education (UM=MOHE) High Impact Research Grant (Grant number E000010-20001). NNH’s work is supported by the University of Malaya Grand Challenge PEACE grant (GC001A-14HTM). The authors would like to thank the Director General of Health, Malaysia for his permission to use the data from the National Health and Morbidity Surveys 1996, 2006 & 2011 and publish this article. Conflicts of interest: None declared.
Funding Information:
It is acknowledged that this study is supported by the University of Malaya=Ministry of Higher Education (UM=MOHE) High Impact Research Grant (Grant number E000010-20001). NNH’s work is supported by the University of Malaya Grand Challenge PEACE grant (GC001A-14HTM). The authors would like to thank the Director General of Health, Malaysia for his permission to use the data from the National Health and Morbidity Surveys 1996, 2006 & 2011 and publish this article.
Publisher Copyright:
© 2018 Jeevitha Mariapun et al.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2018/6/5
Y1 - 2018/6/5
N2 - Background: Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods: We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg=m2 and ≥27.5 kg=m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results: Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion: As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.
AB - Background: Economic development is known to shift the distribution of obesity from the socioeconomically more advantaged to the less advantaged. We assessed the socioeconomic trends in overweight, obesity, and abdominal obesity across a period of significant economic growth. Methods: We used the Malaysian National Health and Morbidity Survey data sets for the years 1996, 2006, and 2011 to analyze the trends among adults aged 30 years and above. The World Health Organization’s Asian body mass index cut-off points of ≥23.0 kg=m2 and ≥27.5 kg=m2 were used to define overweight and obesity, respectively. Abdominal obesity was defined as having a waist circumference of ≥90 cm for men and ≥80 cm for women. Household per-capita income was used as a measure of socioeconomic position. As a summary measure of inequality, we computed the concentration index. Results: Women in Peninsular Malaysia demonstrated patterns that were similar to that of developed countries in which the distributions for overweight, obesity, and abdominal obesity became concentrated among the poor. For women in East Malaysia, distributions became neither concentrated among the rich nor poor, while distributions for men were still concentrated among the rich. Chinese women, particularly from the richest quintile, had the lowest rates and lowest increase in overweight and obesity. All distributions of Chinese women were concentrated among the poor. The distributions of Malay men were still concentrated among the rich, while distributions for Chinese and Indian men and Malay and Indian women were neither concentrated among the rich nor poor. Conclusion: As the country continues to progress, increasing risks of overweight and obesity among the socioeconomically less advantaged is expected.
KW - Developing countries
KW - Economic development
KW - Obesity
KW - Overweight
KW - Socioeconomic status
UR - http://www.scopus.com/inward/record.url?scp=85049216646&partnerID=8YFLogxK
U2 - 10.2188/jea.JE20170001
DO - 10.2188/jea.JE20170001
M3 - Article
C2 - 29657257
AN - SCOPUS:85049216646
SN - 0917-5040
VL - 28
SP - 279
EP - 286
JO - Journal of Epidemiology
JF - Journal of Epidemiology
IS - 6
ER -