142nd APHA Annual Meeting and Exposition

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311409
Obesity highest in parish with greatest proportion of farmers in Jamaica, a lower middle income country

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Colette Cunningham-Myrie, MBBS MPH , Department of Community Health & Psychiatry, The University of West Indies, Mona, Kingston 7, Jamaica
Novie Younger-Coleman, PhD , Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
Marshall Tulloch-Reid, MBBS DSc , Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
Parris Lyew-Ayee Jr., PhD , Mona GeoInformatics Institute, University of the West Indies, Kingston 7, Jamaica
Jasneth Mullings, PhD , Health Research Resource Unit, University of the West Indies, Mona, Kingston 7, Jamaica
Katherine Theall, PhD , Department of Global Community Health and Behavioral Sciences, Tulane School of Public Health and Tropical Medicine, New Orleans, LA
Rainford Wilks, MBBS DM , Epidemiology Research Unit, Tropical Medicine Research Institute, The University of the West Indies, Mona, Kingston 7, Jamaica
Objective

To investigate reasons for geographic variation of obesity in Jamaica 

Study Design and Setting

Using the Jamaica Health and Lifestyle Survey 2008 (JHLS II) parish-specific age-adjusted prevalence estimates of obesity were obtained. Sex-specific odds ratios for obesity by parish were determined using the parish with the lowest obesity prevalence as the referent. Models were adjusted for age, urbanity, physical activity and diet.  

Results

Age-adjusted parish obesity prevalence ranged from 19.5% to 37.8% (1.7-31.0%  in men and 27.4-48.2% in women). St. Elizabeth with the highest proportion of farmers (12.7%) had the highest prevalence of obesity. Among men, the lowest prevalence was seen in Portland the parish with the 4th  highest proportion of farmers (8.6%); and among women, in St. Ann the parish with the 3rdhighest proportion of farmers (9.4%). Logistic regression models revealed that men residing in St. Elizabeth, were 16 times more obese compared to men living in Portland [Odds Ratio (OR), 16.7; 95% CI, 2.1, 134.3). Women residing in St. Elizabeth had twice the odds of being obese compared to those living in St. Ann [Odds Ratio (OR), 2.3; 95% CI, 1.007, 5.3). No significant associations were seen with parish education or poverty levels.

Conclusion

Significant differences in obesity exist across parishes in Jamaica, a country undergoing an epidemiological transition. Counter intuitively, the highest prevalence is in the parish with the greatest proportion of farmers. Further analyses must be conducted to determine what compositional or contextual influences account for this variation to inform prevention efforts in similar populations.

Learning Areas:

Chronic disease management and prevention
Diversity and culture
Epidemiology
Planning of health education strategies, interventions, and programs
Public health or related education
Social and behavioral sciences

Learning Objectives:
Describe briefly the geographical divisions of Jamaica, a small island developing country Name parishes in Jamaica with highest prevalence of obesity Compare geographical differences in prevalence of obesity between Jamaicans and African Americans Discuss compositional and contextual factors that may contribute to differences in geographical variation between developing and developed countries

Keyword(s): Obesity, International Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Since 2002 I have been working as a public health practitioner in chronic disease epidemiology, firstly as the national epidemiologist with responsibility for Chronic Diseases and since 2003 as part of the Cardiovascular Research Group at the Tropical Medicine Research Institute UWI Jamaica. I'm am currently enrolled as a Doctorate of Public Health (DrPH) student with research focus on geographical variation in CNCDs and risk factors.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.