Browsing by Autor "German Vera"

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    Geographical disparities in adult obesity prevalence: small-area analysis of the Chilean National Health Surveys
    (Research Square (United States), 2022) Cinthya Urquidi; Alejandro Sepúlveda-Peñaloza; Francisco Cumsille; Marcela Garrido; Patricia Matus; German Vera
    Abstract Background Previous representative health surveys conducted in Chile evidenced a high obesity prevalence rate among adults, especially in female and urban areas. Nevertheless, these have limited utility for targeted interventions and local source allocation for prevention. This study analyzes the increments in adult obesity prevalence rates and the geographic variation at the regional level. We also assessed whether the obesity rates have different patterns on a smaller geographic level than national and regional ones. Methods This ecological study analyzed data from two representative national samples of adults ≥18 years old, who participated in the last Chilean health surveys, 2009 (n=5,412) and 2016 (n=6,233). Obesity (body mass index≥30 Kg/m2) rates were calculated on the national, regional, and Health Service (HS) levels, being HS the smallest unit of analysis available. Obesity rates and relative increase to early identify target populations and geographic areas, with 95% confidence intervals (95% CI), were calculated using the sampling design of the national surveys, at the national and regional level, and by gender, age groups, and socioeconomic status. The Fay-Herriot (FH) models, using auxiliary data, were fitted for obesity rates estimates at the HS level. Results The relative increase of obesity rate was 37.1% (95%CI 23.3-52.9) at the national level, with a heterogeneous geographic distribution at the regional one. Southern Regions had the highest obesity rates in both surveys (Aysén: 35.2%, 95%CI 26.9-43.5 in 2009, 44.3% 95%CI 37-51.7 in 2016), but higher increases were predominantly in the northern and central areas of the country (relative increase 91.1% 95%CI 39.6-110.1 in Valparaiso and 81.6 95%CI 14.4-196.2 in Tarapacá). Obesity rates were higher in females, older age, and lower socioeconomic groups; nevertheless, relative increases were higher in the opposite ones. The Fay-Herriot estimates showed an obesity rates variation at the HS level, where higher rates tend to converge to specific HS areas of each Region. Conclusion Adult obesity rates and relative increase are diverse across subnational levels and substantially differ from the national estimates, highlighting a pattern that converges to areas with medium-low-income households. Our results emphasize geographical disparities in obesity prevalence among adults.