Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012

Pérez-Ferrer, Carolina; McMunn, Anne; Dommarco, Juan Ángel Rivera; Brunner, Eric J.

doi:10.1371/journal.pone.0090195

Cited by 23 publications

(21 citation statements)

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“…The present study is based on the 2006 and 2012 NHNS surveys, which are representative of the Mexican population. The most recent studies relating SES to obesity in the Mexican adult population were limited either to the 2006 or to the 2012 data [ 35 , 36 ], or focused solely on trends in women and educational categories [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…We obtained predictive margins at given wealth levels and estimated their covariate-adjusted slopes with average marginal effects [ 19 ]. Since area of residence has been suggested to act as a moderator variable [ 20 ], we estimated a model with interactions between area of residence and all covariates and performed joint significance tests for each sex-year on each group of SES indicators. Given the exploratory nature of this research, we presented results by area of residence whenever the group of interactions was significant at the 0.1 level.…”

Section: Methodsmentioning

confidence: 99%

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Time trends and sex differences in associations between socioeconomic status indicators and overweight-obesity in Mexico (2006–2012)

Quezada¹,

Lozada-Tequeanes²

2015

BMC Public Health

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BackgroundAlthough the associations between specific socioeconomic status (SES) indicators and overweight or obesity (OWOB) have been studied in different countries, fewer evidence exists for these associations when multiple SES indicators are considered simultaneously. Furthermore, there are few studies investigating time trends in OWOB and their relation with SES in upper-middle income countries, especially for men. The present study contributes to a better understanding of the nature and evolution of the associations between SES indicators and OWOB in the Mexican adult population.MethodsWe pooled data from the 2006 and 2012 National Health and Nutrition Surveys in Mexico and obtained covariate-adjusted prevalence from a design-based logistic multiple regression model. Covariates included a wealth index, education, occupational status, marital status, and all interactions for each covariate with sex (male/female) and survey year.ResultsFor men, the association between wealth and OWOB remained positive in general but curvature was more evident in 2012. The wealth-OWOB association in women showed an inverted-U pattern at both years with a positive slope that turned into a negative one as wealth increased. Among women, OWOB prevalence at the college/university education level was approximately 12.0 ± 2.4 (percentage points ± standard error) lower compared with the elementary education level. We did not find differences between educational categories for men in 2006, but in 2012 OWOB tended to be higher among the more educated. The prevalence of obesity in women increased at wealth levels from the middle and upper-middle section of the wealth distributions. Overall OWOB prevalence was near 70 % in 2012 for both sexes.ConclusionsAmong Mexican women, the associations between SES indicators and excess body weight were consistent to those found in developed countries. Among Mexican men, higher education was not associated with a lower prevalence of OWOB but the positive association between wealth and OWOB weakened as wealth increased. The overall prevalence of OWOB was very high for both sexes; its reduction should remain a public health priority given the consequences of nutrition-related chronic diseases, disability and health care costs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2608-2) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Time trends and sex differences in associations between socioeconomic status indicators and overweight-obesity in Mexico (2006–2012)

Quezada¹,

Lozada-Tequeanes²

2015

BMC Public Health

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“…The trend for disparities within each socioeconomic variable for each survey was then estimated and compared using a two-way interaction term composed of the socioeconomic variable of interest and a survey year dummy variable (2010 vs 2005), consistent with the methodology of previous studies on the topic. 22 23 …”

Section: Methodsmentioning

confidence: 99%

Temporal trend in socioeconomic inequalities in the uptake of cancer screening programmes in France between 2005 and 2010: results from the Cancer Barometer surveys

et al. 2017

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ObjectivesCancer screening is a form of secondary prevention for a disease which is now the leading cause of death in France. Various socioeconomic indicators have been identified as potential factors for disparities in breast, cervical and colorectal cancer screening uptake. We aimed to identify the socioeconomic inequalities, which persisted in screening uptake for these cancers, and to quantify these disparities over a 5-year period.SettingThe Cancer Barometer was a population-based-survey carried out in 2005 and 2010 in France.ParticipantsA randomly selected sample of participants aged 15–85 years (n=3820 in 2005 and n=3727 in 2010) were interviewed on their participation in breast, cervical and colorectal cancer screening-programmes and their socioeconomic profile.Primary and secondary outcome measuresFor each type of screening programme, we calculated participation rates, OR and relative inequality indices (RII) for participation, derived from logistic regression of the following socioeconomic variables: income, education, occupation, employment and health insurance. Changes in participation between 2005 and 2010 were then analysed.ResultsParticipation rates for breast and colorectal screening increased significantly among the majority of socioeconomic categories, whereas for cervical cancer screening there were no significant changes between 2005 and 2010. RIIs for income remained significant for cervical smear in 2005 (RII=0.25, 95% CI 0.13 to 0.48) and in 2010 (RII=0.31, 95% CI 0.15 to 0.64). RIIs for education in mammography (RII=0.43, 95% CI 0.19 to 0.98) and cervical smear (RII=0.36, 95% CI 0.21 to 0.64) were significant in 2005 and remained significant for cervical smear (RII=0.40, 95% CI 0.22 to 0.74) in 2010.ConclusionsThere was a persistence of socioeconomic inequalities in the uptake of opportunistic cervical cancer screening. Conversely, organised screening programmes for breast and colorectal cancer saw a reduction in relative socioeconomic inequalities, even though the results were not statistically significant. The findings suggest that organised cancer screening programmes may have the potential to reduce socioeconomic disparities in participation.

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“…Further, because this intervention requires little agency from individuals as it modifies the environment in which food choices are made, it is expected to show equal or greater benefit for lower socioeconomic groups [20]. This is very important in countries undergoing the nutrition transition, like Mexico, where obesity prevalence is shifting to socially disadvantaged populations [21].…”

Section: Discussionmentioning

confidence: 99%

Compliance with nutrition standards in Mexican schools and their effectiveness: a repeated cross-sectional study

et al. 2018

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BackgroundMexico approved mandatory nutrient-based standards for foods sold in schools in 2011. The aim of this study was to analyse the association between compliance with nutrition standards for foods sold in schools and children’s school snacks.MethodsData came from three surveys representative of Mexican elementary schools in 13 states and their students (2012, 2013 and 2015); n = 645 children from N = 99 different schools. Information on foods sold in schools and snacks consumed by children was collected through direct observation. Compliance with the standards was defined as the proportion of foods sold in school which met nutrition criteria established by the standards. Snacks were classified as healthy if they contained at least one fruit or vegetable and had no sugar-sweetened beverages. Robust logistic regression models for cross-sectional and repeated surveys aggregated at the school-level were fitted to quantify the association between school compliance with standards and healthy snacks.ResultsOn average across waves 27% of foods sold complied with nutrition standards; 18% of children consumed a healthy snack. For snacks purchased in school, a 10% increase in school compliance with the standards was associated with a 32% increase in the odds of a healthy snack (OR = 1.32; 95%CI 1.09,1.61); no association was observed for snacks brought from home. The odds of a healthy snack increased over time in schools where compliance with the standards improved (OR = 3.89; 95%CI 1.47,10.31) but not in those where compliance remained constant or decreased.ConclusionsOnly a small proportion of children are eating healthy snacks in school. School compliance with standards increases the likelihood of a healthy snack if it is bought at school. Our findings support better implementation of the standards and additional strategies to enhance the policy to achieve its aim of reducing childhood obesity.Electronic supplementary materialThe online version of this article (10.1186/s12889-018-6330-8) contains supplementary material, which is available to authorized users.

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Educational Inequalities in Obesity among Mexican Women: Time-Trends from 1988 to 2012

Cited by 23 publications

References 44 publications

Time trends and sex differences in associations between socioeconomic status indicators and overweight-obesity in Mexico (2006–2012)

Time trends and sex differences in associations between socioeconomic status indicators and overweight-obesity in Mexico (2006–2012)

Temporal trend in socioeconomic inequalities in the uptake of cancer screening programmes in France between 2005 and 2010: results from the Cancer Barometer surveys

Compliance with nutrition standards in Mexican schools and their effectiveness: a repeated cross-sectional study

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