Clinical Epidemiology and Global Health (Nov 2023)
Spatiotemporal change in wealth-based inequalities in overweight/obesity among women of reproductive age in India, 2015–2021
Abstract
Background: Overweight/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. Methods: The 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. Results: Overweight/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. Conclusion: The 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.
