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. 2021 May 4;19(1):24.
doi: 10.1186/s12963-021-00251-6.

Inequality of weight status in urban Cuba: 2001-2010

Peng Nie  1   2   3   4 , Lanlin Ding  5 , Alfonso Sousa-Poza  5   6   7 , Alina Alfonso Leon  8 , Hong Xue  9 , Peng Jia  10   11 , Liang Wang  12 , Youfa Wang  13
Affiliations

Inequality of weight status in urban Cuba: 2001-2010

Peng Nie et al. Popul Health Metr. .

Abstract

Background: Although understanding changes in the body weight distribution and trends in obesity inequality plays a key role in assessing the causes and persistence of obesity, limited research on this topic is available for Cuba. This study thus analyzed changes in body mass index (BMI) and waist circumference (WC) distributions and obesity inequality over a 9-year period among urban Cuban adults.

Methods: Kolmogorov-Smirnov tests were first applied to the data from the 2001 and 2010 National Survey on Risk Factors and Chronic Diseases to identify a rightward shift in both the BMI and WC distributions over the 2001-2010 period. A Shapley technique decomposed the increase in obesity prevalence into a mean-growth effect and a (re)distributional component. A univariate assessment of obesity inequality was then derived by calculating both the Gini and generalized entropy (GE) measures. Lastly, a GE-based decomposition partitioned overall obesity inequality into within-group and between-group values.

Results: Despite some relatively pronounced left-skewing, both the BMI and WC distributions exhibited a clear rightward shift to which the increases in general and central obesity can be mostly attributed. According to the Gini coefficients, both general and central obesity inequality increased over the 2001-2010 period, from 0.105 [95% confidence interval (CI) = 0.103-0.106] to 0.110 [95% CI = 0.107-0.112] and from 0.083 [95% CI = 0.082-0.084] to 0.085 [95% CI = 0.084-0.087], respectively. The GE-based decomposition further revealed that both types of inequality were accounted for primarily by within-group inequality (93.3%/89.6% and 87.5%/84.8% in 2001/2010 for general/central obesity, respectively).

Conclusions: Obesity inequality in urban Cuba worsened over the 2001-2010 time period, with within-group inequality in overall obesity dominant over between-group inequality. In general, the results also imply that the rise in obesity inequality is immune to health care system characteristics.

Keywords: Body mass index; Decomposition; Inequality; Obesity; Urban Cuba; Waist circumference.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
BMI and WC distribution over time. a BMI distribution: 2001–2010. b WC distribution: 2001-2010. c Differences in the BMI and WC ECDF curves: 2010–2001. BMI, body mass index; WC, waist circumstance
Fig. 2
Fig. 2
BMI and WC growth incidence curves. BMI, body mass index; WC, waist circumstance
See this image and copyright information in PMC

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