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Undernutrition among adults in India: the significance of individual-level and contextual factors impacting on the likelihood of underweight across sub-populations.

Abstract：

OBJECTIVE:To investigate the extent to which individual-level as well as macro-level contextual factors influence the likelihood of underweight across adult sub-populations in India. DESIGN:Population-based cross-sectional survey included in India's National Health Family Survey conducted in 2005-06. We disaggregated into eight sub-populations. SETTING:Multistage nationally representative household survey covering 99 % of India's population. SUBJECTS:The survey covered 124 385 females aged 15-49 years and 74 369 males aged 15-54 years. RESULTS:A social gradient in underweight exists in India. Even after allowing for wealth status, differences in the predicted probability of underweight persisted based upon rurality, age/maturity and gender. We found individual-level education lowered the likelihood of underweight for males, but no statistical association for females. Paradoxically, rural young (15-24 years) females from more educated villages had a higher likelihood of underweight relative to those in less educated villages; but for rural mature (>24 years) females the opposite was the case. Christians had a significantly lower likelihood of underweight relative to other socio-religious groups (OR=0·53-0·80). Higher state-level inequality increased the likelihood of underweight across most population groups, while neighbourhood inequality exhibited a similar relationship for the rural young population subgroups only. Individual states/neighbourhoods accounted for 5-9 % of the variation in the prediction of underweight. We found that rural young females represent a particularly highly vulnerable sub-population. CONCLUSIONS:Economic growth alone is unlikely to reduce the burden of malnutrition in India; accordingly, policy makers need to address the broader social determinants that contribute to higher underweight prevalence in specific demographic subgroups.

journal_name

Public Health Nutr

journal_title

Public health nutrition

authors

Siddiqui MZ,Donato R

doi

10.1017/S1368980016001968

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

130-141

issue

eissn

1368-9800

issn

1475-2727

pii

S1368980016001968

journal_volume

pub_type

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Undernutrition among adults in India: the significance of individual-level and contextual factors impacting on the likelihood of underweight across sub-populations.