Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries
Adolescents and young people (10-24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region's population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is c...
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| Veröffentlicht in: | PLoS medicine 2020-12, Vol.17 (12), p.e1003443 |
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| creator | Elia, Christelle Karamanos, Alexis Dregan, Alexandru O'Keeffe, Majella Wolfe, Ingrid Sandall, Jane Morgan, Craig Cruickshank, J Kennedy Gobin, Reeta Wilks, Rainford Harding, Seeromanie |
| description | Adolescents and young people (10-24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region's population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated.
The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10-19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys |
| doi_str_mv | 10.1371/journal.pmed.1003443 |
| format | Article |
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The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10-19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health-related issues.
This study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health.</description><identifier>ISSN: 1549-1676</identifier><identifier>ISSN: 1549-1277</identifier><identifier>EISSN: 1549-1676</identifier><identifier>DOI: 10.1371/journal.pmed.1003443</identifier><identifier>PMID: 33373361</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adolescent Behavior ; Age Factors ; Alcohol use ; Biology and Life Sciences ; Body mass index ; Body weight ; Caribbean Region - epidemiology ; Child ; Child Behavior ; Cross-Sectional Studies ; Demographic aspects ; Economic crisis ; Female ; Health aspects ; Health Surveys ; Humans ; Latin America - epidemiology ; Male ; Medicine and Health Sciences ; Mental disorders ; Mental Health ; Obesity ; Obesity in adolescence ; Overweight ; Pediatric Obesity - diagnosis ; Pediatric Obesity - epidemiology ; Pediatric Obesity - psychology ; People and Places ; Psychological aspects ; Risk Assessment ; Risk Factors ; Sex Factors ; Social Sciences ; Suicidal Ideation ; Suicide ; Suicides & suicide attempts ; Teenagers ; Young Adult</subject><ispartof>PLoS medicine, 2020-12, Vol.17 (12), p.e1003443</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Elia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Elia et al 2020 Elia et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c764t-69ebcb4a7ad3807dbcdab8240d704a045560aad42db916a049e0138722925f8b3</citedby><cites>FETCH-LOGICAL-c764t-69ebcb4a7ad3807dbcdab8240d704a045560aad42db916a049e0138722925f8b3</cites><orcidid>0000-0002-7620-4902 ; 0000-0003-1964-6656 ; 0000-0002-8298-8440 ; 0000-0003-2000-743X ; 0000-0002-4717-7634 ; 0000-0002-1619-604X ; 0000-0001-8126-1760</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771665/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771665/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,725,778,782,862,883,2098,2917,23849,27907,27908,53774,53776,79351,79352</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33373361$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Basu, Sanjay</contributor><creatorcontrib>Elia, Christelle</creatorcontrib><creatorcontrib>Karamanos, Alexis</creatorcontrib><creatorcontrib>Dregan, Alexandru</creatorcontrib><creatorcontrib>O'Keeffe, Majella</creatorcontrib><creatorcontrib>Wolfe, Ingrid</creatorcontrib><creatorcontrib>Sandall, Jane</creatorcontrib><creatorcontrib>Morgan, Craig</creatorcontrib><creatorcontrib>Cruickshank, J Kennedy</creatorcontrib><creatorcontrib>Gobin, Reeta</creatorcontrib><creatorcontrib>Wilks, Rainford</creatorcontrib><creatorcontrib>Harding, Seeromanie</creatorcontrib><title>Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries</title><title>PLoS medicine</title><addtitle>PLoS Med</addtitle><description>Adolescents and young people (10-24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region's population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated.
The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10-19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health-related issues.
This study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health.</description><subject>Adolescent</subject><subject>Adolescent Behavior</subject><subject>Age Factors</subject><subject>Alcohol use</subject><subject>Biology and Life Sciences</subject><subject>Body mass index</subject><subject>Body weight</subject><subject>Caribbean Region - epidemiology</subject><subject>Child</subject><subject>Child Behavior</subject><subject>Cross-Sectional Studies</subject><subject>Demographic aspects</subject><subject>Economic crisis</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health Surveys</subject><subject>Humans</subject><subject>Latin America - epidemiology</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Mental Health</subject><subject>Obesity</subject><subject>Obesity in adolescence</subject><subject>Overweight</subject><subject>Pediatric Obesity - 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epidemiology</topic><topic>Child</topic><topic>Child Behavior</topic><topic>Cross-Sectional Studies</topic><topic>Demographic aspects</topic><topic>Economic crisis</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health Surveys</topic><topic>Humans</topic><topic>Latin America - epidemiology</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Mental disorders</topic><topic>Mental Health</topic><topic>Obesity</topic><topic>Obesity in adolescence</topic><topic>Overweight</topic><topic>Pediatric Obesity - diagnosis</topic><topic>Pediatric Obesity - epidemiology</topic><topic>Pediatric Obesity - psychology</topic><topic>People and Places</topic><topic>Psychological aspects</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Sex Factors</topic><topic>Social Sciences</topic><topic>Suicidal Ideation</topic><topic>Suicide</topic><topic>Suicides & suicide attempts</topic><topic>Teenagers</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Elia, Christelle</creatorcontrib><creatorcontrib>Karamanos, Alexis</creatorcontrib><creatorcontrib>Dregan, Alexandru</creatorcontrib><creatorcontrib>O'Keeffe, Majella</creatorcontrib><creatorcontrib>Wolfe, Ingrid</creatorcontrib><creatorcontrib>Sandall, Jane</creatorcontrib><creatorcontrib>Morgan, Craig</creatorcontrib><creatorcontrib>Cruickshank, J Kennedy</creatorcontrib><creatorcontrib>Gobin, Reeta</creatorcontrib><creatorcontrib>Wilks, Rainford</creatorcontrib><creatorcontrib>Harding, Seeromanie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Canada</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><collection>PLoS Medicine</collection><jtitle>PLoS medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Elia, Christelle</au><au>Karamanos, Alexis</au><au>Dregan, Alexandru</au><au>O'Keeffe, Majella</au><au>Wolfe, Ingrid</au><au>Sandall, Jane</au><au>Morgan, Craig</au><au>Cruickshank, J Kennedy</au><au>Gobin, Reeta</au><au>Wilks, Rainford</au><au>Harding, Seeromanie</au><au>Basu, Sanjay</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries</atitle><jtitle>PLoS medicine</jtitle><addtitle>PLoS Med</addtitle><date>2020-12-29</date><risdate>2020</risdate><volume>17</volume><issue>12</issue><spage>e1003443</spage><pages>e1003443-</pages><issn>1549-1676</issn><issn>1549-1277</issn><eissn>1549-1676</eissn><abstract>Adolescents and young people (10-24 years old) in the Latin America and the Caribbean (LAC) region represent approximately 25% of the region's population. Since the 2008 global economic crisis, the pace of reduction in poverty and income inequality in the LAC region has stalled. The region is characterised by high levels of inequities and is also vulnerable to many natural disasters. Food systems are changing with increased availability and marketing of packaged and fast foods and sugar-sweetened drinks. Adolescence is a formative phase of the life course with multiple physical, emotional and social changes which can make them vulnerable to health problems. We assess the potential impact of macro-determinants, human and economic development as well as income inequality, on 2 top-ranking regional priorities for adolescent nutrition and mental health, using measures of overweight and suicidal ideation and planning which some have shown to be associated.
The Global School-based Health Survey (GSHS) is a nationally representative self-administered, school-based survey. We examined overweight/obesity and suicidal ideation with planning by gross domestic product (GDP) per capita or human development index (HDI) in 10-19-year-old adolescents from 21 LAC countries between 2009 and 2013. Sample sizes varied from 943 in Anguilla to 27,988 in Argentina. A total of 55,295 adolescents had a measure of overweight/obesity status, and 59,061 adolescents reported about suicidal ideation with planning. There was equal representation by sex in the surveys (52% girls and 48% boys). A total of 28.8% of boys and 28.1% of girls had overweight/obesity, and 7.5% of boys and 17.5% of girls reported suicidal ideation with planning over the last 12 months. Adjusted for individual socioeconomic and risk behaviours, and relative to the highest GDP per capita tertile, the middle tertile was associated with 42% (95% confidence interval (CI) 59% to 17%, p = 0.003) and 32% (95% CI 60% to 5%, p = 0.023), and the lowest tertile with 40% (95% CI 55% to 19%, p = 0.001) and 46% (95% CI 59% to 29%, p < 0.001) lower chances of overweight/obesity for girls and boys, respectively. A similar positive effect was seen with HDI, with lowest chances of overweight in the lowest tertile compared with the highest tertile for both sexes. Overweight/obesity was positively related with suicidal ideation with planning for girls (odds ratio (OR) 1.12, 95% CI 1.02 to 1.22, p = 0.009) and weakly related for boys (OR 1.09, 95% CI 0.96 to 1.24, p = 0.182). In contrast to overweight/obesity status, suicidal ideation with planning was not related to macro-level indices despite both outcomes sharing common individual socioeconomic and risk behaviour correlates. Limitations include the dominance of Argentinians in the sample (40%), the exclusion of vulnerable adolescents who dropped out of school, and reporting bias due to stigma of mental health-related issues.
This study shows that economic and human development were positively associated with adolescent overweight/obesity but not with suicidal ideation with planning. We also observed an interconnectedness between overweight/obesity and suicide ideation with planning among girls. These findings highlight the importance of strategies that engage with both upstream and downstream determinants to improve adolescent nutrition and mental health.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33373361</pmid><doi>10.1371/journal.pmed.1003443</doi><orcidid>https://orcid.org/0000-0002-7620-4902</orcidid><orcidid>https://orcid.org/0000-0003-1964-6656</orcidid><orcidid>https://orcid.org/0000-0002-8298-8440</orcidid><orcidid>https://orcid.org/0000-0003-2000-743X</orcidid><orcidid>https://orcid.org/0000-0002-4717-7634</orcidid><orcidid>https://orcid.org/0000-0002-1619-604X</orcidid><orcidid>https://orcid.org/0000-0001-8126-1760</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1549-1676 |
| ispartof | PLoS medicine, 2020-12, Vol.17 (12), p.e1003443 |
| issn | 1549-1676 1549-1277 1549-1676 |
| language | eng |
| recordid | cdi_plos_journals_2490318178 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Public Library of Science (PLoS) Journals Open Access; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Adolescent Adolescent Behavior Age Factors Alcohol use Biology and Life Sciences Body mass index Body weight Caribbean Region - epidemiology Child Child Behavior Cross-Sectional Studies Demographic aspects Economic crisis Female Health aspects Health Surveys Humans Latin America - epidemiology Male Medicine and Health Sciences Mental disorders Mental Health Obesity Obesity in adolescence Overweight Pediatric Obesity - diagnosis Pediatric Obesity - epidemiology Pediatric Obesity - psychology People and Places Psychological aspects Risk Assessment Risk Factors Sex Factors Social Sciences Suicidal Ideation Suicide Suicides & suicide attempts Teenagers Young Adult |
| title | Association of macro-level determinants with adolescent overweight and suicidal ideation with planning: A cross-sectional study of 21 Latin American and Caribbean Countries |
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