Double burden of malnutrition in 115 Latin American cities: An ecological analysis

Abstract

Abstract Background Using harmonized aggregated data on health and socioeconomic environments in Latin American cities (from the Salud Urbana en América Latina (SALURBAL) study), we assessed the association of city‐level contextual factors with the prevalence of the double burden of malnutrition (DBM) in urban settings. Methods This ecological study used aggregated survey data from 115 Latin American cities within five countries (Colombia, El Salvador, Guatemala, Mexico and Peru) collected between 2008 and 2016. DBM was defined as the coexistence of stunting in children under 5 years and overweight/obesity among adult women at the city‐level. We ran ordinal logistic regression models to examine macrolevel contextual factors that might explain the city‐level DBM. Independent variables were city‐level socioeconomic development index, women educational attainment and women labor force. Results Out of 115 Latin American cities, 19 cities from five countries were experiencing a moderate to high burden of stunting and simultaneously a very high burden of overweight/obesity in adult women. All cities had overweight/obesity prevalence above 40%. A poor social environment, higher levels of women education and greater women labor force at the city level were associated with greater levels of DBM. Conclusion Some Latin American cities are still facing moderate and high DBM, while all cities are experiencing an alarming high burden of overweight/obesity. Social macro‐level factors such as poor social environment, high women education and high women labor force were associated with the coexistence of stunting in children and overweight/obesity in adult women.

Keywords

• double burden
• malnutrition
• obesity
• overweight
• socioeconomic factors
• stunting