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. 2018 Mar 30:42:e29.
doi: 10.26633/RPSP.2018.29. eCollection 2018.

Stature in adults as an indicator of socioeconomic inequalities in Mexico

Lilia V Castro-Porras  1 , Mario E Rojas-Russell  2 , Ángeles Aedo-Santos  1 , Emma G Wynne-Bannister  1 , Malaquías López-Cervantes  1
Affiliations

Stature in adults as an indicator of socioeconomic inequalities in Mexico

Lilia V Castro-Porras et al. Rev Panam Salud Publica. .

Abstract
in English, Spanish, Portuguese

Objective: To estimate the association between stature in Mexican adults and some sociodemographic factors.

Methods: We studied a sample of 30 970 subjects, using anthropometric data from the 2012 National Health and Nutrition Survey (ENSANUT 2012). The first quartile was used as the cutoff to define short stature. We analyzed differences among stature strata for sociodemographic variables by using the Kruskal-Wallis test. We estimated odds ratios to measure the association between stature and sociodemographic variables, controlling for potential confounders.

Results: Persons from the southern region of the country were some three times as likely to be of short stature than were subjects in the northern region. The stature difference between the Mexican states with the highest and the lowest average stature was larger than the average difference in stature between Mexico and the United States of America. Adults who had had less than six years of schooling presented the highest prevalence of short stature, regardless of sex, region of the country, place of residence (rural or urban), or the proportion of indigenous language speakers in a state. In addition, the stratum with the highest marginalization (percentage of the population lacking education and services, with a low income, and living in a small community) showed the highest prevalence of short stature.

Conclusion: In Mexico, adults who are of short stature have unequal living conditions when compared to those of average or high stature, and this could drive increases in health inequity.

Objetivo: Establecer la asociación entre la estatura de los mexicanos adultos y algunos factores sociodemográficos.

Métodos: Sobre la base de datos antropométricos de la Encuesta Nacional de Salud y Nutrición de 2012 (ENSANUT 2012), estudiamos una muestra de 30 970 sujetos. Para definir la estatura baja, el umbral se estableció en el primer cuartil. Analizamos las diferencias entre los distintos estratos de estatura en relación con variables sociodemográficas utilizando la prueba de Kruskal-Wallis. Calculamos las razones de posibilidades para medir la asociación entre la estatura y las variables sociodemográficas, con control de posibles factores de confusión.

Resultados: Las personas de la zona meridional del país tenían alrededor de tres veces más probabilidades de ser de estatura baja que las personas de la zona septentrional. La diferencia entre los estados mexicanos con la estatura promedio más alta y la estatura promedio más baja fue mayor que la diferencia promedio respecto de la estatura entre México y los Estados Unidos de América. La prevalencia más alta de estatura baja se registró en los adultos con menos de seis años de escolaridad, independientemente del sexo, la zona del país, el lugar de residencia (rural o urbano) y la proporción de hablantes de lenguas indígenas en un estado. Además, la prevalencia más alta de estatura baja se observó en el estrato de población más marginada (porcentaje de habitantes sin escolaridad ni servicios, con ingresos bajos y que vivían una comunidad pequeña).

Conclusiones: En México, las condiciones de vida de los adultos de estatura baja son más desfavorables que las de los adultos de estatura media o alta, y esto podría contribuir a aumentar la inequidad en materia de salud.

Objetivo: Estimar a associação entre a estatura em adultos mexicanos e fatores sociodemográficos.

Métodos: Foi estudada uma amostra de 30.970 indivíduos com base em dados antropométricos obtidos da Pesquisa Nacional sobre Saúde e Nutrição de 2012 (ENSANUT 2012). O primeiro quartil foi usado como valor de corte para definir baixa estatura. Foram analisadas as diferenças entre os estratos de estatura para as variáveis sociodemográficas com o uso do teste de Kruskal- Wallis. Foram estimados os odds ratios para medir a associação entre a estatura e as variáveis sociodemográficas, controlando-se os potenciais fatores de confusão.

Resultados: Os indivíduos da região sul do país apresentaram uma chance quase três vezes maior de ter baixa estatura em comparação aos indivíduos da região norte. A diferença de estatura entre os estados mexicanos com a estatura média maior e a estatura média menor foi maior que a diferença média em estatura entre o México e os Estados Unidos. Os adultos com menos de seis anos de escolaridade apresentaram a prevalência mais elevada de baixa estatura, independentemente do sexo, região do país, zona de residência (rural ou urbana) ou proporção de falantes de línguas indígenas em um estado. Além disso, o estrato com maior marginação (porcentagem de habitantes com carência de educação e serviços, de baixa renda e vivendo em uma pequena comunidade) apresentou a prevalência mais elevada de baixa estatura.

Conclusão: No México, os adultos com baixa estatura têm condições de vida desiguais comparados aos adultos com estatura média ou alta, contribuindo para maior iniquidade em saúde.

Keywords: Mexico; Socioeconomic factors; adult; body height; indigenous population.

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Conflict of interest statement

Conflict of interests: None declared.

Figures

FIGURE 1
FIGURE 1. Prevalence of short stature in Mexican adults, by categories of years of schooling in men and women, adjusted for region and residence, in study of stature in adults and socioeconomic inequalities in Mexicoᵃ
FIGURE 2
FIGURE 2. Odds ratio, with 95% confidence interval, for short stature in adults in Mexico City and the states of Mexico, using the national mean as a reference category, in study of stature in adults and socioeconomic inequalities in Mexico
FIGURE 3
FIGURE 3. Prevalence of short statureᵃ in adults in Mexico City and the states of Mexico,b by category of prevalence, in study of stature in adults and socioeconomic inequalities in Mexico
a Short stature is ≤ 148.5 cm for women and ≤ 161.1 cm for men. b Mexico City and the states of Mexico are indicated in the map by either a number or an abbreviation. The four numbered locations are: 1, Mexico City; 2, Morelos; 3, Tlaxcala; and 4, Aguascalientes. The remaining states are: BC, Baja California; BCS, Baja California Sur; CAMP, Campeche; COAH, Coahuila; COL, Colima; CHIS, Chiapas; CHIH, Chihuahua; DUR, Durango; GTO, Guanajuato; GRO, Guerrero; HGO, Hidalgo; JAL, Jalisco; MEX, México; MICH, Michoacán; NAY, Nayarit; NL, Nuevo León; OAX, Oaxaca; PUE, Puebla; QRO, Querétaro; QR, Quintana Roo; SLP, San Luis Potosí; SIN, Sinaloa; SON, Sonora; TAB, Tabasco; TAMS, Tamaulipas; VER, Veracruz; YUC, Yucatán; and ZAC, Zacatecas.
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