Yevgeniy Goryakin

Obesity and socioeconomic status in developing countries: a systematic review

We undertook a systematic review of studies assessing the association between socioeconomic status (SES) and measured obesity in low‐ and middle‐income countries (defined by the World Bank as countries with per capita income up to US

Does active commuting improve psychological wellbeing? Longitudinal evidence from eighteen waves of the British Household Panel Survey

12,275) among children, men and women. The evidence on the subject has grown significantly since an earlier influential review was published in 2004. We find that in low‐income countries or in countries with low human development index (HDI), the association between SES and obesity appears to be positive for both men and women: the more affluent and/or those with higher educational attainment tend to be more likely to be obese. However, in middle‐income countries or in countries with medium HDI, the association becomes largely mixed for men and mainly negative for women. This particular shift appears to occur at an even lower level of per capita income than suggested by an influential earlier review. By contrast, obesity in children appears to be predominantly a problem of the rich in low‐ and middle‐income countries.

Economic development, urbanization, technological change and overweight: What do we learn from 244 Demographic and Health Surveys?

Objective The aim of this study is to explore the relationship between active travel and psychological wellbeing. Method This study used data on 17,985 adult commuters in eighteen waves of the British Household Panel Survey (1991/2–2008/9). Fixed effects regression models were used to investigate how (i.) travel mode choice, (ii.) commuting time, and (iii.) switching to active travel impacted on overall psychological wellbeing and how (iv.) travel mode choice impacted on specific psychological symptoms included in the General Health Questionnaire. Results After accounting for changes in individual-level socioeconomic characteristics and potential confounding variables relating to work, residence and health, significant associations were observed between overall psychological wellbeing (on a 36-point Likert scale) and (i.) active travel (0.185, 95% CI: 0.048 to 0.321) and public transport (0.195, 95% CI: 0.035 to 0.355) when compared to car travel, (ii.) time spent (per 10 minute change) walking (0.083, 95% CI: 0.003 to 0.163) and driving (− 0.033, 95% CI: − 0.064 to − 0.001), and (iii.) switching from car travel to active travel (0.479, 95% CI: 0.199 to 0.758). Active travel was also associated with reductions in the odds of experiencing two specific psychological symptoms when compared to car travel. Conclusion The positive psychological wellbeing effects identified in this study should be considered in cost–benefit assessments of interventions seeking to promote active travel.

The impact of economic, political and social globalization on overweight and obesity in the 56 low and middle income countries.

Highlights • We study association between income, socioeconomic status (SES), technological change and overweight risk.• Positive association between SES and overweight weakens as the gross domestic product (GDP) per capita goes up.• Urban residence is positively related to overweight at all levels of GDP per capita.• Several proxies of technological progress also positively related to overweight risk.

Social capital and self-reported general and mental health in nine Former Soviet Union countries.

Anecdotal and descriptive evidence has led to the claim that globalization plays a major role in inducing overweight and obesity in developing countries, but robust quantitative evidence is scarce. We undertook extensive econometric analyses of several datasets, using a series of new proxies for different dimensions of globalization potentially affecting overweight in up to 887,000 women aged 15–49 living in 56 countries between 1991 and 2009. After controlling for relevant individual and country level factors, globalization as a whole is substantially and significantly associated with an increase in the individual propensity to be overweight among women. Surprisingly, political and social globalization dominate the influence of the economic dimension. Hence, more consideration needs to be given to the forms of governance required to shape a more health-oriented globalization process.

Smoking status, nicotine dependence and happiness in nine countries of the former Soviet Union

Social capital has been proposed as a potentially important contributor to health, yet most of the existing research tends to ignore the challenge of assessing causality in this relationship. We deal with this issue by employing various instrumental variable estimation techniques. We apply the analysis to a set of nine former Soviet countries, using a unique multi-country household survey specifically designed for this region. Our results confirm that there appears to be a causal association running from several dimensions of individual social capital to general and mental health. Individual trust appears to be more strongly related to general health, while social isolation- to mental health. In addition, social support and trust seem to be more important determinants of health than the social capital dimensions that facilitate solidarity and collective action. Our findings are remarkably robust to a range of different specifications, including the use of instrumental variables. Certain interaction effects are also found: for instance, untrusting people who live in communities with higher aggregate level of trust are even less likely to experience good health than untrusting people living in the reference communities.

The impact of diabetes on employment in Mexico

Background The US Food and Drug Administration has established a policy of substantially discounting the health benefits of reduced smoking in its evaluation of proposed regulations because of the cost to smokers of the supposed lost pleasure they suffer by no longer smoking. This study used data from nine countries of the former Soviet Union (fSU) to explore this association in a setting characterised by high rates of (male) smoking and smoking-related mortality. Methods Data came from a cross-sectional population-based study undertaken in 2010/2011 in Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Information was collected from 18 000 respondents aged ≥18 on smoking status (never, ex-smoking and current smoking), cessation attempts and nicotine dependence. The association between these variables and self-reported happiness was examined using ordered probit regression analysis. Results In a pooled country analysis, never smokers and ex-smokers were both significantly happier than current smokers. Smokers with higher levels of nicotine dependence were significantly less happy than those with a low level of dependence. Conclusions This study contradicts the idea that smoking is associated with greater happiness. Moreover, of relevance for policy in the fSU countries, given the lack of public knowledge about the detrimental effects of smoking on health but widespread desire to quit reported in recent research, the finding that smoking is associated with lower levels of happiness should be incorporated in future public health efforts to help encourage smokers to quit by highlighting that smoking cessation may result in better physical and emotional health.

Fruit and vegetable consumption in the former Soviet Union: the role of individual- and community-level factors

This study explores the impact of diabetes on employment in Mexico using data from the Mexican Family Life Survey (MxFLS) (2005), taking into account the possible endogeneity of diabetes via an instrumental variable estimation strategy. We find that diabetes significantly decreases employment probabilities for men by about 10 percentage points (p<0.01) and somewhat less so for women - 4.5 percentage points (p<0.1)--without any indication of diabetes being endogenous. Further analysis shows that diabetes mainly affects the employment probabilities of men and women above the age of 44 and also has stronger effects on the poor than on the rich, particularly for men. We also find some indication for more adverse effects of diabetes on those in the large informal labour market compared to those in formal employment. Our results highlight--for the first time--the detrimental employment impact of diabetes in a developing country.

Micro- and meso-level influences on obesity in the former Soviet Union: a multi-level analysis.

Objective To explain patterns of fruit and vegetable consumption in nine former Soviet Union countries by exploring the influence of a range of individual- and community-level determinants. Design Cross-sectional nationally representative surveys and area profiles were undertaken in 2010 in nine countries of the former Soviet Union as part of the Health in Times of Transition (HITT) study. Individual- and area-level determinants were analysed, taking into account potential confounding at the individual and area level. Setting Armenia, Azerbaijan, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine. Subjects Adult survey respondents (n 17 998) aged 18–95 years. Results Being male, increasing age, lack of education and lack of financial resources were associated with lower probability of consuming adequate amounts of fruit or vegetables. Daily fruit or vegetable consumption was positively correlated with the number of shops selling fruit and vegetables (for women) and with the number of convenience stores (for men). Billboard advertising of snacks and sweet drinks was negatively related to daily fruit or vegetable consumption, although the reverse was true for billboards advertising soft drinks. Men living near a fast-food outlet had a lower probability of fruit or vegetable consumption, while the opposite was true for the number of local food restaurants. Conclusions Overall fruit and vegetable consumption in the former Soviet Union is inadequate, particularly among lower socio-economic groups. Both individual- and community-level factors play a role in explaining inadequate nutrition and thus provide potential entry points for policy interventions, while the nuanced influence of community factors informs the agenda for future research.

Price elasticities of alcohol demand:evidence from Russia

BACKGROUND Limited evidence exists on obesity in the former Soviet Union (fSU), particularly its micro- and meso-level determinants. The objectives of this study were to determine age- and gender-adjusted prevalence of self-reported overweight and obesity in nine fSU countries; explore the relationship between individual and household (micro-level) factors and obesity; and explore the relationship between features of nutritional and physical environments (meso-level) and obesity. METHODS Data were collected from 18,000 adults using household surveys and from 333 communities using community profiles in Azerbaijan, Armenia, Belarus, Georgia, Kazakhstan, Kyrgyzstan, Moldova, Russia and Ukraine in 2010. Individual- and community-level determinants of self-reported obesity (body mass index ≥ 30 kg/m(2)) were analysed using multi-level random intercept logistic regression models. RESULTS A total of 13% of the males and 18% of the females were categorized as obese. Factors associated with obesity in males were older age, increasing educational achievement, declining self-reported health, alcohol consumption and automobile ownership. Males who were current smokers, not married and perceived physical activity to be important were less likely to be obese. For females, obesity was associated with older age, completion of secondary-level education, declining self-reported health and average household financial situation. Unmarried women were less likely to be obese. Multi-level analysis indicated that individuals living in communities with higher presence of garbage were more likely to be obese. CONCLUSIONS This is the first study to examine both micro- and meso-level influences on obesity in fSU using multi-level analysis. Findings indicate a similar obesity risk profile to countries in Western Europe and North America.