Abstract
BackgroundIndia’s economic development and urbanisation in recent decades has varied considerably between states. Attempts to assess how overweight (including obesity) varies by socioeconomic position at the national level may mask considerable sub-national heterogeneity. We examined the socioeconomic patterning of overweight among adults in India’s most and least economically developed states between 1998 and 2016.MethodsWe used state representative data from the National Family Health Surveys from 1998 to 99, 2005–06 and 2015–16. We estimated the prevalence of overweight by socioeconomic position in men (15–54 years) and women (15–49 years) from India’s most and least economically developed states using multilevel logistic regressions.ResultsWe observed an increasing trend of overweight prevalence among low socioeconomic position women. Amongst high socioeconomic position women, overweight prevalence either increased to a smaller extent, remained the same or even declined between 1998 and 2016. This was particularly the case in urban areas of the most developed states, where in the main analysis, the prevalence of overweight increased from 19 to 33% among women from the lowest socioeconomic group between 1998 and 2016 compared to no change among women from the highest socioeconomic group. Between 2005 and 2016, the prevalence of overweight increased to similar extents among high and low socioeconomic status men, irrespective of residence.ConclusionsThe converging prevalence of overweight by socioeconomic position in India’s most developed states, particularly amongst urban women, implies that this subpopulation may be the first to exhibit a negative association between socioeconomic position and overweight in India. Programs aiming to reduce the increasing overweight trends may wish to focus on poorer women in India’s most developed states, amongst whom the increasing trend in prevalence has been considerable.
Highlights
India’s economic development and urbanisation in recent decades has varied considerably between states
Rather than split the continuous Body Mass Index (BMI) measure into multiple subcategories of overweight, we used this classification as the main aim of the paper was to analyse trends in excess adiposity, and research has found an elevated risk of noncommunicable disease (NCD) and mortality beyond a BMI of 24.99 kg/m2 [21, 22]
The largest increase was observed among women in the least developed states, where the percentage of overweight respondents increased from 6 to 19% between National Family Health Survey (NFHS) 2 and 4
Summary
India’s economic development and urbanisation in recent decades has varied considerably between states. Attempts to assess how overweight (including obesity) varies by socioeconomic position at the national level may mask considerable sub-national heterogeneity. We examined the socioeconomic patterning of overweight among adults in India’s most and least economically developed states between 1998 and 2016. In the early stages of economic development and urbanisation, overweight and obesity prevalence tends to be higher among individuals of a higher socioeconomic position (SEP), arguably due to an increased financial capability to meet and exceed nutritional requirement [6,7,8,9]. The prevalence of overweight, and the extent of the increase in its prevalence in recent decades, varies considerably sub-nationally [1,2,3]. Little is known about variation in the subnational socioeconomic patterning of overweight
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