Universidad Peruana Cayetano Heredia

Global inequalities in the double burden of malnutrition and associations with globalisation: a multilevel analysis of Demographic and Healthy Surveys from 55 low-income and middle-income countries, 1992-2018.

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dc.contributor.author Seferidi, Paraskevi
dc.contributor.author Hone, Thomas
dc.contributor.author Duran, Ana Clara
dc.contributor.author Bernabé Ortiz, Antonio
dc.contributor.author Millett, Christopher
dc.date.accessioned 2022-03-23T16:54:20Z
dc.date.available 2022-03-23T16:54:20Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/11473
dc.description.abstract Background: Low-income and middle-income countries (LMICs) face a double burden of malnutrition (DBM), whereby overnutrition and undernutrition coexist within the same individual, household, or population. This analysis investigates global inequalities in household-level DBM, expressed as a stunted child with an overweight mother, and its association with economic, social, and political globalisation across country income and household wealth. Methods: We pooled anthropometric and demographic data for 1 132 069 children (aged <5 years) and their mothers (aged 15–49 years) from 189 Demographic and Health Surveys in 55 LMICs between 1992 and 2018. These data were combined with country-level data on economic, social, and political globalisation from the Konjunkturforschungsstelle Globalisation Index and gross national income (GNI) from the World Bank. Multivariate associations between DBM and household wealth, GNI, and globalisation and their interactions were tested using multilevel logistic regression models with country and year fixed-effects and robust standard errors clustered by country. Findings: The probability of DBM was higher among richer households in poorer LMICs and poorer households in richer LMICs. Economic globalisation was associated with higher odds of DBM among the poorest households (odds ratio 1·49, 95% CI 1·20–1·86) compared with the richest households. These associations attenuated as GNI increased. Social globalisation was associated with higher odds of DBM (1·39, 95% CI 1·16–1·65), independently of household wealth or country income. No associations were identified between political globalisation and DBM. Interpretation: Increases in economic and social globalisation were associated with higher DBM, although the impacts of economic globalisation were mostly realised by the world's poorest. The economic patterning of DBM observed in this study calls for subpopulation-specific double-duty actions, which should further aim to mitigate the potential negative and unequal impacts of globalisation. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Lancet. Global health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Global inequalities en_US
dc.subject malnutrition en_US
dc.subject globalisation en_US
dc.subject Demographic and Health Surveys en_US
dc.subject low-income countries en_US
dc.subject middle-income countries en_US
dc.title Global inequalities in the double burden of malnutrition and associations with globalisation: a multilevel analysis of Demographic and Healthy Surveys from 55 low-income and middle-income countries, 1992-2018. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/S2214-109X(21)00594-5
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#1.06.09
dc.relation.issn 2214-109X


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