Date of Award

Fall 12-16-2019

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Public Health

First Advisor

Dr. Ike Okosun

Second Advisor

Dr. Sheryl Strasser

Third Advisor

Dr. Ruiyan Luo

Abstract

Background: Adolescent obesity is a serious public health problem in high-income countries of the world. However, despite the sociodemographic, cultural background and structural healthcare access and sustainable development differences among high-income countries, results of obesity studies are often generalize to all high-income countries, including high-income, developing countries. Few studies exist, describing the relationship between obesity and associated factors in high-income, developing countries. Hence this investigation aims to describe the epidemiology of obesity and determinants that may exist among school-based population in six high-income, developing countries in Latin America and the Caribbean.

Methods: Data from the Global School-Based Student Health Survey for Anguilla, Bahamas, Curacao, Uruguay, Chile, and Argentina was used to compare prevalence of obesity and associated risk factors. Multivariate logistic regression analyses were used to estimate risk of obesity between countries.

Results: Regional prevalence rate of obesity was 19%; 31.3% for the Caribbean, 17.6% for Latin America, 35.8% for the Bahamas, 31.7 for Anguilla, 32.3% for Chile, 25.5% for Curacao 17.5% for Uruguay, and 16.5% for Argentina. Increased odds of obesity in the Caribbean was estimated for females (AOR: 1.44, 95%CI: 1.16 - 1.79), and bullying victims (AOR: 1.36, 95% CI: 1.01 - 1.82), and bullying victimization (AOR: 1.99, 95% CI: 1.28 - 3.08) and being 14 years old (AOR: 1.59, 95% CI: 1.02 - 2.47) in Latin America. Decreased odds of obesity was associated with engaging in physical activity in Anguilla (AOR: 0.31, 95% CI: 0.15 - 0.65), whereas increased odds of obesity was associated with female gender in the Bahamas (AOR: 1.65, 95% CI: 1.23 - 2.23), bullying victimization in Curacao (AOR: 2.02, 95% CI: 1.27 - 3.21), Uruguay (AOR: 1.36, 95% CI: 1.06 - 1.81) and Argentina (AOR: 1.28, 95% CI: 1.05 - 1.56), age 14 years olds in Uruguay (AOR: 1.33, 95% CI: 1.02 - 1.73), 15 years in Uruguay (AOR: 1.51, 95% CI: 1.07 - 2.12), Chile (AOR: 2.21, 95% CI: 1.51 - 3.22) and Argentina (AOR: 1.35, 95% CI: 1.02 - 1.79).This dissertation was the first to compare these obesity risk factors between high-income, developing Latin American and Caribbean countries and sub-regions.

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