Assessment of Body Mass Index (BMI) as a Measure of Socioeconomic Status (SES) of Adults in Ghana
The living conditions and types of food that a person consumes affect his/her state of health. As the society improves socially and economically, the lifestyles of the people change with respect to their food and eating habits. There is therefore the tendency of people shying away from the homemade foods, which may be nutritionally superior to the consumption of fast foods. With an improvement in the economy, people in the developing countries especially, think they must adopt a more modernized lifestyle which negatively affect their nutritional status.
The Global Nutrition report recorded about 33.6% and 12.2% of adult Ghanaians to be overweight and obese respectively. It was also indicated that there has been an increase in the prevalence rate from 2010-2014. This may be strongly due to change in eating patterns and physical activity, which may also be partly owing to improvement of the economy of Ghana.
This trend has led to diet-related diseases not only affecting the affluent societies but also the developing world; if not more badly. The Ghana demographic and health survey (GDHS) unearthed that non-communicable diseases such as cardiovascular diseases, cancer, diabetes and other diseases cause about 60% of deaths globally of which about 80% occur in developing countries. Incidence of circulatory system diseases and cancers for the developed world included 21% (2,544) and 45.6% (5,522) respectively while that for the developing world was 9.5% (3,802) and 24.5% (9,778) for circulatory system diseases and cancer respectively. Obviously as the economy develops, eating habits and physical activity patterns change and this leads to increase in BMI and therefore increase in lifestyle related diseases. It is therefore necessary to assess one’s nutritional status.
Information on SES, certain anthropometric measurements (body measurements) such as weight, height and body circumference are means of assessing the general health of an individual and nutritional status as well as the risk of suffering certain disease conditions. For instance, the loss of weight in the elderly may give a clue to depression or cancer.
The food a person eats and therefore his/her body composition is however, largely dependent on his/her SES. SES is define as an individual’s position within a hierarchical social structure influenced by a combination of variables such as occupation, education, income, wealth and place of residence. It is important for researchers to consider SES when conducting health studies, because people of different SES levels may have different access to formal education, medical care, healthy food, and physical activity opportunities. To make reliable informative statements about the nutritional status of a subject under study, it may sometimes be necessary to combine some of these parameters to give a new index which may then be used for assessment e.g. BMI, a weight-for-height measurement. This study thus would ascertain how BMI correlates with SES, which may also relate to risk of diet, related non-communicable diseases of adults.
Materials and Methods:
The study conducted was a cross-sectional study involving adults aged ≥ 25 years. Standard procedures were used to take the measurements weight in kilogram and height in meters. Interviewer-administered WHO Stepwise questionnaires were modified to gather all other information. The data was analyzed with SPSS Version 16 and Microsoft Excel 2003 Office Version. To determine the socioeconomic status, the subjects were classified into three socioeconomic groups based on their possessions and incomes. Each response was weighted and given comparative value for each respondent. The total scores obtained from each respondent were categorized into High and Low SES.
Results and Discussion:
The distribution of the respondents according to age as available that 48% of the respondents comprising 22 males and 26 females were in the age range of between 30 and 39 years, whilst 36% made up of 8 males and 28 females respectively were between the ages of 50-59 years. About 5 males and 11 females forming 16% were in the 40-49 age groups. The proportion of males to females in this study was 35% to 65% respectively.
Socioeconomic status has many indicators some of which are educational level, income, occupation, house ownership, access to services such as water, etc. All the information on the questionnaire was combined using scores to obtain the SES of the respondents in this study,shows the pattern of the educational level of the subjects. Approximately 44 (67.7%) of the female subjects had education below secondary level, compared to 14 (40%) of the males. About 60% of the males had had skilled or higher education, whilst only 26% of the females had had such education.
Close to 60% of the total population had just primary or secondary education. A few females had no education (6.2%). The occupations of the respondents were put into two main groups as formal sector and informal sector. This categorization was based on the level of skill and educational level needed for such occupation. Seventy-six percent (76%) of the subjects were put into the informal sector thus 54(83.1%) of the females subjects and 22 (62.9%) of males subjects. The income ranges of the respondents are only 9% of the total population earned above $125 in a month. Twenty four percent (24%) made less than or just above the minimum salary for Ghanaians ($8.4). Fifty percent of the respondents netted a little less than three times the minimum salary.
BMI together with SES, can be used to determine the nutritional status of adults as well as the risk of nutrition related diseases which have a direct relationship with the amounts of fat present in the body. Ghanaian women have low socioeconomic status and overweight/obesity is more prevalent as compared to men. This portrays that SES is inversely proportional to BMI (the lower the SES, the higher the BMI) in women but directly proportional in men (the lower the SES, the lower the BMI).
Endocrinology and Metabolism:Open Access