Sally Humphries

Factors associated with BMI, underweight, overweight, and obesity among adults in a population of rural south India: a cross-sectional study

BackgroundOverweight, obesity, and related chronic diseases are becoming serious public health concerns in rural areas of India. Compounded with the existing issue of underweight, such concerns expose the double burden of disease and may put stress on rural healthcare. The purpose of this article was to present the prevalence and factors associated with underweight, overweight, and obesity in an area of rural south India.MethodsDuring 2013 and 2014, a random sample of adults aged 20–80 years were selected for participation in a cross-sectional study that collected information on diet (using a food frequency questionnaire), physical activity (using the Global Physical Activity Questionnaire), socioeconomic position (using a wealth index), rurality (using the MSU rurality index), education, and a variety of descriptive factors. BMI was measured using standard techniques. Using a multivariate linear regression analysis and multivariate logistic regression analyses, we examined associations between BMI, overweight, obesity, and underweight, and all potential risk factors included in the survey.ResultsAge and sex-adjusted prevalence of overweight, obesity class I, and obesity class II were 14.9, 16.1, and 3.3 % respectively. Prevalence of underweight was 22.7 %. The following variables were associated with higher BMI and/or increased odds of overweight, obesity class I, and/or obesity class II: Low physical activity, high wealth index, no livestock, low animal fat consumption, high n-6 polyunsaturated fat consumption, television ownership, time spent watching television, low rurality index, and high caste. The following variables were associated with increased odds of underweight: low wealth index, high rurality index, and low intake of n-6 PUFAs.ConclusionUnderweight, overweight, and obesity are prevalent in rural regions of southern India, indicating a village-level dual burden. A variety of variables are associated with these conditions, including physical activity, socioeconomic position, rurality, television use, and diet. To address the both underweight and obesity, policymakers must simultaneously focus on encouraging positive behaviour through education and addressing society-level risk factors that inhibit individuals from achieving optimal health.

Determinants of temporary labour migration in southern India

ABSTRACT We present new data from three village panchayats in northwest Tamil Nadu and investigate the associations between demographic and socioeconomic factors with temporary labour migration from this setting. Individual (n = 1110) and household (n = 278) level logistic regression models were used to demonstrate how factors at each of these levels can influence temporary labour migration trajectories. Young males were most likely to temporarily migrate for work from this region. Additionally, large households from historically disadvantaged castes with marginal land and housing were most likely to have at least one migrant member. Households with multiple migrant members appear to use temporary migration to cope with serious deprivation relative to households with only one migrant member. These findings provide a strong case that can be compared to other settings in India and can be used to inform improved policy and targeted development initiatives to support temporary migrant workers and their households.

The internal migration-development nexus: Evidence from southern India:

This study examines the extent to which the internal migration-development nexus is operational in four panchayats or village councils in northwest Tamil Nadu. We investigate who participates in labor migration in this context and explore the experiences of and outcomes from labor migration for migrant workers and their households. In addition, we examine the motivations for migration among migrant households and the barriers to migration among non-migrant households. We argue that internal labor migration can contribute to development in this setting. However, recognition of the barriers to and within migration is needed to frame subsequent policy discussions and rural development planning.

Decoding the Type 2 Diabetes Epidemic in Rural India

ABSTRACT Type 2 diabetes mellitus is an escalating public health problem in India, associated with genetic susceptibility, dietary shift, and rapid lifestyle changes. Historically a disease of the urban elite, quantitative studies have recently confirmed rising prevalence rates among marginalized populations in rural India. To analyze the role of cultural and sociopolitical factors in diabetes onset and management, we employed in-depth interviews and focus groups within a rural community of Tamil Nadu. The objectives of the study were to understand sources and extent of health knowledge, diabetes explanatory models, and the impact of illness on individual, social, and familial roles. Several cultural, socioeconomic, and political factors appear to contribute to diabetes in rural regions of India, highlighting the need to address structural inequities and empower individuals to pursue health and well-being on their own terms.

Men and women farmers’ perceptions of adopting improved diets for pigs in Uganda: decision-making, income allocation, and intra-household strategies that mitigate relative disadvantage

BackgroundThe roles and responsibilities of men and women in east African smallholder pig-raising households and the entitlements each can claim from pig-enterprise income are unknown. The article is a qualitative gender-and-household-head-disaggregated exploration of Ugandan smallholder pig farmers’ perceptions. Asset ownership, control, and access; division of labour; and decision-making related to pig rearing and pig-enterprise income are presented in the context of the potential impact of adopting improved diets for pigs (a productivity improvement).ResultsPotential benefits of improved diet adoption included faster pig growth; increased farmer income and pig population; new on-farm employment and produce market opportunities; and improved pig market opportunities and family- and community-level well-being. Contradictory views about the potential impact of diet adoption on labour requirements and feed costs, and the inclusion of seasonal, home-grown ingredients were expressed. Concerns about people and pigs competing for food and personal safety were also voiced. Women allocated pig-enterprise income to provide for their children, household, and extended family, and spent only the remaining income on themselves. Men allocated income to meet personal needs, and to provide for their children, wife, second wife/family, extended family, and lovers. Men and women in female-headed households (WFHH) had overt decision-making ability over the pig enterprise and pig-enterprise income. Some women in male-headed households (WMHH) had overt decision-making ability over the pig enterprise and pig-enterprise income when their husband allowed it, or failed to provide, or was away. Pig ownership and labour investment by WMHH did not guarantee that women had decision-making ability or benefitted from pig-enterprise income. Some WMHH employed covert strategies which mitigated their relative disadvantage. Threat of domestic violence inhibited the decision-making ability of WMHH. Polygyny reduced intra-household communication transparency.ConclusionsDiet adoption could benefit smallholder pig-raising households and farming communities, but lack of funds and human/pig food competition could limit adoption. Men, WFHH, and some WMHH had overt decision-making ability over the pig enterprise and pig-enterprise income. Men allocated income to benefit themselves, and their multiple families and lovers. Women allocated income to benefit their families and spent only surplus income on themselves. Women employed covert strategies to mitigate their relative disadvantage.

Burden and Determinants of Anemia in a Rural Population in South India: A Cross-Sectional Study

Background/Objectives To determine the prevalence and determinants of blood haemoglobin level and mild, moderate, and severe anemia in a sample of adults from rural Tamil Nadu, India. Subjects/Methods We recruited a sample of men and nonpregnant women aged 20 years and older. Clinical health measures included blood haemoglobin concentration and body mass index. We assessed associations between anemia outcomes and sociodemographic and dietary factors using linear and logistic regression modeling. Results A total of 753 individuals (412 women and 341 men) participated in this study. The prevalence of anemia was 57.2% among women and 39.3% among men (P<0.001). Prevalence of anemia increased with age among men (P<0.001) but not women (P>0.05). Iron intake was low; 11.7% women and 24.1% of men reported iron intakes above recommended dietary allowances (P<0.001). Factors (OR (95% CI)) associated with mild or moderate anemia among women included television ownership (0.27 (0.13, 0.58)), livestock ownership (0.46 (0.28, 0.75)), refined grain consumption (1.32 (1.02, 1.72)), meat consumption (0.84 (0.71, 0.99)), and commercial agriculture production (mild: 4.6 (1.1, 18.8); moderate: 6.8 (1.98, 23.1)). Factors associated with mild, moderate, or severe anemia among men included rurality (0.50 (0.25, 0.99)), sugar consumption (1.04 (1.01, 1.06)), egg consumption (0.80 (0.65, 0.99)), and high caste (7.3 (1.02, 52.3)). Conclusion Both women and men in this region may be particularly vulnerable to anemia, and future research must expand beyond dietary risk factors to examine the impacts of sociodemographic and environmental factors.