Spatiotemporal change in wealth-based inequalities in overweight/obesity among women of reproductive age in India, 2015–2021

Abstract

BackgroundOverweight/obesity poses significant global health concerns, especially affecting women. This study aimed to measure changes in wealth-based inequality in overweight/obesity among women of reproductive age (WRA) across states of India from 2015 to 2021 and identify the contributing factors to this inequality. MethodsThe study used information on 582,851 and 587,435 women aged 15–49 from National Family Health Survey (NFHS)-4 (2015-16) and NFHS-5 (2019-21), respectively. Erreygers Concentration Index (ECI) was employed to measure the change in inequality over time. Further, ECI was decomposed to unravel the contributing factors to this inequality. ResultsOverweight/obesity among WRA in India increased from 20.3 % in NFHS-4 to 23.7 % in NFHS-5. A significant pro-rich inequality in overweight/obesity was observed at the national level and across all 28 states of India during both NFHS-4 and NFHS-5. The national wealth-based inequality reduced marginally over the study period (ECI: 0.25 in NFHS-4, ECI: 0.23 in NFHS-5), but at the state level, it rose in 8 states and declined in 16 states. Punjab witnessed the most significant increase (ECI: 0.10 in NFHS-4, ECI: 0.18 in NFHS-5) in inequality, while Maharashtra (ECI: 0.24 in NFHS-4, ECI: 0.16 in NFHS-5) saw the most significant decrease in inequality. The decomposition analysis results revealed that women's education, mass media exposure, and place of residence were major contributors, contributing more than 80 % to wealth-based inequality in overweight/obesity. ConclusionThe study highlights the growing prevalence of overweight/obesity among WRA in India, emphasizing that wealth-related inequalities in the prevalence of overweight/obesity represent a significant public health concern both at the national and state levels in India.