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Geography of underweight and overweight among women in India: A multilevel analysis of 3204 neighborhoods in 26 states

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  • Ackerson, Leland K.
  • Kawachi, Ichiro
  • Barbeau, Elizabeth M.
  • Subramanian, S.V.

Abstract

We investigated the geographic distribution and the relationship with neighborhood wealth of underweight and overweight in India. Using multilevel modeling techniques, we calculated state-specific smoothed shrunken state residuals of overweight and underweight, neighborhood and state variation of nutritional status, and the relationships between neighborhood wealth and nutritional status of 76,681 women living in 3204 neighborhoods in 26 Indian states. We found a substantial variation in overweight and underweight at the neighborhood and state levels, net of what could be attributed to individual-level factors. Neighborhood wealth was associated with increased levels of overweight and decreased levels of underweight, and was found to modify the relationship between personal living standard and nutritional status. These findings suggest that interventions to address the double burden of undernutrition and overnutrition in India must take into account state and neighborhood characteristics in order to be successful.

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  • Ackerson, Leland K. & Kawachi, Ichiro & Barbeau, Elizabeth M. & Subramanian, S.V., 2008. "Geography of underweight and overweight among women in India: A multilevel analysis of 3204 neighborhoods in 26 states," Economics & Human Biology, Elsevier, vol. 6(2), pages 264-280, July.
    • Handle: RePEc:eee:ehbiol:v:6:y:2008:i:2:p:264-280
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    9. Darren J. Mayne & Geoffrey G. Morgan & Bin B. Jalaludin & Adrian E. Bauman, 2019. "Area-Level Walkability and the Geographic Distribution of High Body Mass in Sydney, Australia: A Spatial Analysis Using the 45 and Up Study," IJERPH, MDPI, vol. 16(4), pages 1-29, February.
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    11. Mowafi, Mona & Khadr, Zeinab & Subramanian, S.V. & Bennett, Gary & Hill, Allan & Kawachi, Ichiro, 2011. "Are neighborhood education levels associated with BMI among adults in Cairo, Egypt?," Social Science & Medicine, Elsevier, vol. 72(8), pages 1274-1283, April.
    12. Grafova, Irina B. & Freedman, Vicki A. & Lurie, Nicole & Kumar, Rizie & Rogowski, Jeannette, 2014. "The difference-in-difference method: Assessing the selection bias in the effects of neighborhood environment on health," Economics & Human Biology, Elsevier, vol. 13(C), pages 20-33.
    13. Jinkook Lee & McGovern, Mark E. & David E. Bloom & P. Arokiasamy & Arun Risbud & Jennifer O?Brien & Varsha Kale & Peifeng Hu, 2015. "Education, Gender, and State-Level Gradients in the Health of Older Indians: Evidence from Biomarker Data," Working Paper 228841, Harvard University OpenScholar.
    14. Antonio Boing & S. Subramanian, 2015. "The influence of area-level education on body mass index, waist circumference and obesity according to gender," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 60(6), pages 727-736, September.
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