Abstract
BackgroundAlthough 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.MethodsKolmogorov-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.ResultsDespite 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).ConclusionsObesity 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.
Highlights
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
Study population characteristics Over the 2001–2010 period, body mass index (BMI) increased by approximately 0.6 kg/m2, waist circumference (WC) by 2.4 cm, general obesity by nearly 4%, and central obesity by around 8% (Table 1)
Our study identified the presence of a clear rightward shift in both the BMI and WC distributions, to which most of the increase in general (56%) and central obesity (82/114% for male/female) can be attributed
Summary
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. Its prevalence is rising, especially in North America [4], Europe [5], and Asia [6, 7], with rates quadrupling among males (3 to 12%) and more than doubling among females (7 to 16%) [8] Most of this increase in obesity prevalence is attributable to either the entire population growing heavier (i.e., a rightward shift in the bodyweight distribution) or more rapid weight gain in one subpopulation (i.e., an increase in distributional left-skewness and rising obesity inequality). Recent work for China, in contrast, documented a clear rightward distributional shift combined with a leftward skewing among adults aged 20+ over the 1991–2011 period [11] Such obesity inequality, being an important indicator of well-being, plays a pivotal role in assessing obesity’s negative social effects (e.g., discrimination and harassment), as well as adult obesity persistence [11]. This prevalence of general overweight and obesity is projected to increase from about 58% (67%) in 2010 to a staggering 94% (89%) in 2050 for males (females), the highest among all Latin American countries [14]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
