Socioeconomic inequalities in underweight children: a cross-sectional analysis of trends in West Africa over two decades.

OBJECTIVE: To study trends in socioeconomic inequalities in underweight children in West Africa, and specifically to analyse the concentration index of underweight inequalities and measure inequalities in the risk of being malnourished by household wealth index. DESIGN: Cross-sectional study. SETTING: The study used 50 Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys conducted between 1999 and 2020 across 14 countries by the DHS and UNICEF. PARTICIPANTS: The study included 481 349 children under the age of 5 years. PRIMARY AND SECONDARY OUTCOME MEASURES: The analysis used three variables: weight-for-age index, household wealth index and household residence. The inequality concentration index for underweight children and the relative risk of being underweight between 2000 and 2020 were calculated. RESULTS: The prevalence of underweight in West Africa showed a downward trend from 2000 to 2020. Nonetheless, the prevalence of underweight children under 5 years of age is still very high in West Africa compared with other sub-Saharan African countries, and the sustainable development objective is yet to be achieved. There was a wide disparity among countries and significant socioeconomic inequalities in underweight children within countries. The proportions of underweight children were concentrated in poor households in all countries in West Africa and over all periods. Socioeconomic inequalities in underweight children were more significant in countries where the prevalence of underweight was low. These inequalities were more pronounced in urban areas in West Africa from 2000 to 2020. CONCLUSIONS AND RELEVANCE: There is a high concentration of socioeconomic inequalities in underweight children in disadvantaged households in West Africa.

Life-course socioeconomic status and obesity: a scoping review protocol.

OBJECTIVE: We aim to explore the literature that studies the links between life-course socioeconomic status and weight status and characterize the life-course approach used. INTRODUCTION: Obesogenic environments are increasing rapidly in deprived environments, and cross-sectional studies have shown limitations in explaining the links between these environments and obesity. The life-course approach has been proposed recently to better understand the links between socioeconomic status and weight status. INCLUSION CRITERIA: Studies that identify life-course socioeconomic status and longitudinal built environment indicators and associate them with body weight indicators between January 2000 and January 2023. METHODS: Studies in French or English were searched in Medline (PubMed), Web of Science and GeoBase (Embase) according to the strategies formulated for each database. The selected studies were exported to Covidence for evaluation according to the inclusion/exclusion criteria. RESULTS: The main results retained are the association between longitudinal socioeconomic indicators and weight measures; longitudinal built environment indicators and the measures of weight.

Food environment trajectories: a sequence analysis from the CARTaGENE cohort.

OBJECTIVE: The purpose of this study was to create a typology of longitudinal exposure to food environment based on socio-economic context. DESIGN: Food environment trajectories were modelled using a sequence analysis method, followed by a logistic regression to describe those trajectories. SETTING: The study took place in Quebec, Canada, using food environment data from 2009, 2011 and 2018 merged with participants' demographic and socio-economic characteristics. PARTICIPANT: At recruitment, 38 627 participants between the ages of 40 and 69 years from six urban areas in Quebec were included in the CARTaGENE cohort study. The cohort was representative of the Quebec urban population within this age range. RESULTS: Our study revealed five trajectories of food access over time: (1) limited access to food stores throughout the study period, (2) limited access improving, (3) good access diminishing, (4) good access throughout the period and (5) low access throughout the period. Logistic regression analysis showed that participants who were unable to work (OR = 1·42, CI = 1·08-1·86), lived in households with five or more persons (OR = 1·69, CI = 1·17-2·42) and those living in low-income households (OR = 1·32, CI = 1·03-1·71) had higher odds of experiencing a disadvantaged food environment trajectory. Additionally, the level of education and age of participants were associated with the odds of experiencing a disadvantaged food environment trajectory. CONCLUSIONS: The study demonstrates that people facing socio-economic disadvantage are more likely to experience a disadvantaged food environment trajectory over time.