The weight of work: the association between maternal employment and overweight in low- and middle-income countries
Abstract Background Maternal employment has increased in low-and middle-income countries (LMIC) and is a hypothesized risk factor for maternal overweight due to increased income and behavioral changes related to time allocation. However, few studies have investigated this relationship in LMIC. Metho...
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doaj-6926d06101124cc2ba612a78e4215e262020-11-24T22:24:01ZengBMCInternational Journal of Behavioral Nutrition and Physical Activity1479-58682017-10-0114111010.1186/s12966-017-0522-yThe weight of work: the association between maternal employment and overweight in low- and middle-income countriesVanessa M. Oddo0Sara N. Bleich1Keshia M. Pollack2Pamela J. Surkan3Noel T. Mueller4Jessica C. Jones-Smith5Department of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public HealthDepartment of Health Policy and Management, Harvard T.H. Chan School of Public HealthDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public HealthDepartment of International Health, Social and Behavioral Interventions Program, Johns Hopkins Bloomberg School of Public HealthDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthDepartment of International Health, Center for Human Nutrition, Johns Hopkins Bloomberg School of Public HealthAbstract Background Maternal employment has increased in low-and middle-income countries (LMIC) and is a hypothesized risk factor for maternal overweight due to increased income and behavioral changes related to time allocation. However, few studies have investigated this relationship in LMIC. Methods Using cross-sectional samples from Demographic and Health Surveys, we investigated the association between maternal employment and overweight (body mass index [BMI] ≥ 25 kg/m2) among women in 38 LMIC (N = 162,768). We categorized mothers as formally employed, informally employed, or non-employed based on 4 indicators: employment status in the last 12 months; aggregate occupation category (skilled, unskilled); type of earnings (cash only, cash and in-kind, in-kind only, unpaid); and seasonality of employment (all year, seasonal/occasional employment). Formally employed women were largely employed year-round in skilled occupations and earned a wage (e.g. professional), whereas informally employed women were often irregularly employed in unskilled occupations and in some cases, were paid in-kind (e.g. domestic work). For within-country analyses, we used adjusted logistic regression models and included an interaction term to assess heterogeneity in the association by maternal education level. We then used meta-analysis and meta-regression to explore differences in the associations pooled across countries. Results Compared to non-employed mothers, formally employed mothers had higher odds of overweight (pooled odds ratio [POR] = 1.3; 95% Confidence Interval [CI] 1.2, 1.4) whereas informally employed mothers, compared to non-employed mothers, had lower odds of overweight (POR = 0.72; 95% CI: 0.64, 0.81). In 14 LMIC, the association varied by education. In these countries, the magnitude of the formal employment-overweight association was larger for women with low education (POR = 1.5; 95% CI: 1.1, 1.9) compared to those with high education (POR = 1.2; 95% CI: 1.0, 1.3). Conclusions Formally employed mothers in LMIC have higher odds of overweight and the association varies by educational attainment in 14 countries. This knowledge highlights the importance of workplace initiatives to reduce the risk of overweight among working women in LMIC.http://link.springer.com/article/10.1186/s12966-017-0522-yMaternal employmentOverweightLow- and middle-income countriesNutrition transition |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vanessa M. Oddo Sara N. Bleich Keshia M. Pollack Pamela J. Surkan Noel T. Mueller Jessica C. Jones-Smith |
spellingShingle |
Vanessa M. Oddo Sara N. Bleich Keshia M. Pollack Pamela J. Surkan Noel T. Mueller Jessica C. Jones-Smith The weight of work: the association between maternal employment and overweight in low- and middle-income countries International Journal of Behavioral Nutrition and Physical Activity Maternal employment Overweight Low- and middle-income countries Nutrition transition |
author_facet |
Vanessa M. Oddo Sara N. Bleich Keshia M. Pollack Pamela J. Surkan Noel T. Mueller Jessica C. Jones-Smith |
author_sort |
Vanessa M. Oddo |
title |
The weight of work: the association between maternal employment and overweight in low- and middle-income countries |
title_short |
The weight of work: the association between maternal employment and overweight in low- and middle-income countries |
title_full |
The weight of work: the association between maternal employment and overweight in low- and middle-income countries |
title_fullStr |
The weight of work: the association between maternal employment and overweight in low- and middle-income countries |
title_full_unstemmed |
The weight of work: the association between maternal employment and overweight in low- and middle-income countries |
title_sort |
weight of work: the association between maternal employment and overweight in low- and middle-income countries |
publisher |
BMC |
series |
International Journal of Behavioral Nutrition and Physical Activity |
issn |
1479-5868 |
publishDate |
2017-10-01 |
description |
Abstract Background Maternal employment has increased in low-and middle-income countries (LMIC) and is a hypothesized risk factor for maternal overweight due to increased income and behavioral changes related to time allocation. However, few studies have investigated this relationship in LMIC. Methods Using cross-sectional samples from Demographic and Health Surveys, we investigated the association between maternal employment and overweight (body mass index [BMI] ≥ 25 kg/m2) among women in 38 LMIC (N = 162,768). We categorized mothers as formally employed, informally employed, or non-employed based on 4 indicators: employment status in the last 12 months; aggregate occupation category (skilled, unskilled); type of earnings (cash only, cash and in-kind, in-kind only, unpaid); and seasonality of employment (all year, seasonal/occasional employment). Formally employed women were largely employed year-round in skilled occupations and earned a wage (e.g. professional), whereas informally employed women were often irregularly employed in unskilled occupations and in some cases, were paid in-kind (e.g. domestic work). For within-country analyses, we used adjusted logistic regression models and included an interaction term to assess heterogeneity in the association by maternal education level. We then used meta-analysis and meta-regression to explore differences in the associations pooled across countries. Results Compared to non-employed mothers, formally employed mothers had higher odds of overweight (pooled odds ratio [POR] = 1.3; 95% Confidence Interval [CI] 1.2, 1.4) whereas informally employed mothers, compared to non-employed mothers, had lower odds of overweight (POR = 0.72; 95% CI: 0.64, 0.81). In 14 LMIC, the association varied by education. In these countries, the magnitude of the formal employment-overweight association was larger for women with low education (POR = 1.5; 95% CI: 1.1, 1.9) compared to those with high education (POR = 1.2; 95% CI: 1.0, 1.3). Conclusions Formally employed mothers in LMIC have higher odds of overweight and the association varies by educational attainment in 14 countries. This knowledge highlights the importance of workplace initiatives to reduce the risk of overweight among working women in LMIC. |
topic |
Maternal employment Overweight Low- and middle-income countries Nutrition transition |
url |
http://link.springer.com/article/10.1186/s12966-017-0522-y |
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