Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households

dc.contributor.advisorAlaba, Olufunke
dc.contributor.authorBrown, James Craig
dc.date.accessioned2019-02-18T10:43:20Z
dc.date.available2019-02-18T10:43:20Z
dc.date.issued2018
dc.date.updated2019-02-18T08:35:18Z
dc.description.abstractThe co-existence of under- and over-nutrition, termed the double burden of malnutrition (DBM), is associated with a high prevalence of both communicable and non-communicable diseases and is becoming a large public health concern. In general, DBM development is associated with populations undergoing a nutrition transition and urbanisation. DBM can exist at a population, household or individual level. The household form is particularly difficult to target with interventions, because households, and particularly mother-child pairs, are often consuming the same foods. For example, frequent consumption of energy dense and nutrient poor ('junk’) foods can concurrently result in overweight adults, but underweight children. Although, household DBM is linked with poverty and food insecurity and its prevalence is steadfastly increasing it is yet to be investigated in South Africa, despite this country being one of the most inequitable in the world. In addition, South Africa has a high prevalence of obesity (34% of adult females obese), undernutrition (9% of children underweight) and poverty (25% unemployment). with a high prevalence of poverty and food insecurity. Therefore, this study aims to estimate the prevalence, and examine the associated factors of DBM, in South African households. Using the nationally representative data from 2014, South Africa National Income Dynamic Survey wave 4, , the prevalence of household DBM pairs (overweight/obese mother and underweight/stunted child) was estimated. Multivariate logistic regression was applied to examine the relationship between mother-child DBM pairs and (i) socioeconomic status (per capita household income, number of household residents, and mother’s race, education, marital status, household head status), (ii) food security (per capita food expenditure), and (iii) potentially important confounders (mother’s age and urban/rural household). The regression was adjusted for mother’s age as a potential confounder. Mother-child DBM prevalence was 11% in this nationally representative sample of South Africa. Mother’s characteristics of being African (adjusted odds [aOR]: 1.3; 95% confidence intervals [95%CI]: 1.0-1.7) and married (aOR: 1.4, 95%CI: 1.1-1.6) were associated with increased odds of DBM. In contrast mother’s having tertiary education (aOR: 0.7, 95%CI: 0.5-1.0) and greater household per capita income (aOR: 0.9, 95%CI: 0.8-1.0) were protective against DBM. This South African household DBM prevalence is higher than most other developing countries and is associated with mother’s being African, married and having less education; as well as households with less per capita income. This high prevalence warrants urgent attention by policy makers to further investigate this issue in South Africa. Moreover, interventions such as Brazil’s “Green my Favela” should be considered to reduce the cost and increase the supply of nutritious foods to impoverishes households of South Africa.
dc.identifier.apacitationBrown, J. C. (2018). <i>Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households</i>. (). University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit. Retrieved from http://hdl.handle.net/11427/29606en_ZA
dc.identifier.chicagocitationBrown, James Craig. <i>"Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households."</i> ., University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2018. http://hdl.handle.net/11427/29606en_ZA
dc.identifier.citationBrown, J. 2018. Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Brown, James Craig AB - The co-existence of under- and over-nutrition, termed the double burden of malnutrition (DBM), is associated with a high prevalence of both communicable and non-communicable diseases and is becoming a large public health concern. In general, DBM development is associated with populations undergoing a nutrition transition and urbanisation. DBM can exist at a population, household or individual level. The household form is particularly difficult to target with interventions, because households, and particularly mother-child pairs, are often consuming the same foods. For example, frequent consumption of energy dense and nutrient poor ('junk’) foods can concurrently result in overweight adults, but underweight children. Although, household DBM is linked with poverty and food insecurity and its prevalence is steadfastly increasing it is yet to be investigated in South Africa, despite this country being one of the most inequitable in the world. In addition, South Africa has a high prevalence of obesity (34% of adult females obese), undernutrition (9% of children underweight) and poverty (25% unemployment). with a high prevalence of poverty and food insecurity. Therefore, this study aims to estimate the prevalence, and examine the associated factors of DBM, in South African households. Using the nationally representative data from 2014, South Africa National Income Dynamic Survey wave 4, , the prevalence of household DBM pairs (overweight/obese mother and underweight/stunted child) was estimated. Multivariate logistic regression was applied to examine the relationship between mother-child DBM pairs and (i) socioeconomic status (per capita household income, number of household residents, and mother’s race, education, marital status, household head status), (ii) food security (per capita food expenditure), and (iii) potentially important confounders (mother’s age and urban/rural household). The regression was adjusted for mother’s age as a potential confounder. Mother-child DBM prevalence was 11% in this nationally representative sample of South Africa. Mother’s characteristics of being African (adjusted odds [aOR]: 1.3; 95% confidence intervals [95%CI]: 1.0-1.7) and married (aOR: 1.4, 95%CI: 1.1-1.6) were associated with increased odds of DBM. In contrast mother’s having tertiary education (aOR: 0.7, 95%CI: 0.5-1.0) and greater household per capita income (aOR: 0.9, 95%CI: 0.8-1.0) were protective against DBM. This South African household DBM prevalence is higher than most other developing countries and is associated with mother’s being African, married and having less education; as well as households with less per capita income. This high prevalence warrants urgent attention by policy makers to further investigate this issue in South Africa. Moreover, interventions such as Brazil’s “Green my Favela” should be considered to reduce the cost and increase the supply of nutritious foods to impoverishes households of South Africa. DA - 2018 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2018 T1 - Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households TI - Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households UR - http://hdl.handle.net/11427/29606 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/29606
dc.identifier.vancouvercitationBrown JC. Socioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households. []. University of Cape Town ,Faculty of Health Sciences ,Health Economics Unit, 2018 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/29606en_ZA
dc.language.isoeng
dc.publisher.departmentHealth Economics Unit
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subject.otherHealth Economics
dc.titleSocioeconomic status (SES), food insecurity and the double burden of malnutrition within South African households
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPH
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