PAHO Launches New Publication—Obesity and Poverty

Obesity and Poverty: A New Public Health Challenge is an up-to-date examination of the prevalence of overweight and obesity in Latin America and Caribbean countries and in impoverished populations in developed countries. The publication will be presented in Jamaica on May 16^th, 2000 at the Pegasus Hotel in Kingston, Jamaica.

This publication looks at medium and long-term harmful consequences of overweight and obesity and explores their implications for planning public health interventions. The book analyzes how the region’s countries experience the nutritional transition process that is underway worldwide, a process that is tied to the global demographic and epidemiological transition. In this context, the increase in obesity and overweight observed in the Hemisphere coexists with a risk factor that differs from traditional risk factors seen in developed countries due to the persistence or the increase of inequalities and inequities in health.

This book helps us understand that the rising trend in obesity and overweight is part of a worldwide demographic and epidemiological transition and that this trend is not a concomitant manifestation of development. The 12 articles presented in the covers the situation in Latin America and the Caribbean but also that of impoverished populations in developed countries.

This publication does not presume to be a full discussion of the complexity of this global problem, a problem already typified as an "epidemic" by the Centers for Disease Control and Prevention in Atlanta, USA. The book seeks rather to present the economic, sociocultural and environmental determinants of obesity in a few selected countries in Latin America and the Caribbean but also in underprivileged populations in developed countries.

In this frame, the first section of the book first analyses the determinants of obesity among the poor in Latin America and the Caribbean: the authors disclose the different characteristics of the "poor" obese person and the "rich" one, evaluating influence in obesity of the nutritional and sociocultural factors as the acculturation process of Latin America vis-á-vis the patterns of developed countries.

In the same section, an article about the situation in Argentina contains important elements that deserve the attention of food companies worldwide, since they could extract guidelines and strategies on how to better serve the nutritional needs of the population. As a demonstration of the global attributes of obesity, Professor Albert Stunkard from the University of Pennsylvania presents a review of studies conducted in the USA, as the Midtown Manhattan Study and the recent Hispanic Health and Nutrition Survey (HANES) administered to the Hispanic population. The description of activity patterns in Central America are an invaluable information source for Education and Recreation planners, Sports and Medicine specialists, among many other professionals.

In all these articles we find data proving the impact of gender based factors in obesity which make us not only raise eyebrows because they provide evidence of a critical expression of health inequity in the Hemisphere.

The second section of the book includes four articles that describe the epidemiological transition in Chile, Cuba, and Brazil. It also includes the proposed typology for the Latin American and Caribbean countries according to the characteristics of the phase of the demographic and epidemiological transition in which each country is found, with the identification of 3 different clusters. Jamaica is placed in the first cluster, together with Barbados, Chile, Costa Rica, Cuba, Puerto Rico and Uruguay. These countries have had since 1950 the lowest fertility rate, the highest life expectancy, the lowest proportion of population under 15 years of age and the highest proportion above 65 years of age. Indicators in the first cluster¾ where Puerto Rico belongs to¾ also show very low infant and maternal mortality but the highest mortality rates for cancer.

The third section of the publication deals with the methodological aspects that should be taken into account when studying obesity from the public health viewpoint. It is only recently that obesity has gained recognition as a public health problem and the authors of the two articles in this section explain why it is indeed a public health problem. Besides the high health care costs associated with obesity, it is an etiological risk factor for a number or other chronic debilitating diseases that are also of major public health importance, as diabetes, coronary heart diseases, ostheoarthritis and some cancers.

The fourth and last section of the book includes an article linking poor fetal and child growth and obesity later in life. From this correlation, the authors predict that cardiovascular disease rates will rise dramatically in Latin America over the next few decades. Averting such an epidemic will require both adequate nutrition during fetal development and early childhood and prevention of obesity in adulthood. The development of strategies dealing with both these risk factors is a public health challenge for the Hemisphere. The last article suggests measures that can be taken in adolescence for reducing or preventing the risks associated with obesity in adulthood.

The Pan American Health Organization offers this publication to the general public and to researchers, students, communicators and politicians charged with planning and executing activities designed to promote the population’s health and well being.

This publication can be purchased online from the PAHO Bookstore. For more information about the book launching, please call PAHO Office in Kingston, Jamaica: 1-876-967-4626.