title: Richer but fatter: the unintended consequences of microcredit financing on household health and expenditure in Jamaica.
abstract: OBJECTIVE
  To determine whether there was a difference in wealth and cardiovascular disease (CVD) risk between microcredit loan beneficiaries and community-matched non-beneficiaries (controls).
  
  
  METHODS
  Seven hundred and twenty-six households of microcredit loan beneficiaries were matched with 726 controls by age, sex and community. A standardised interviewer administered questionnaire was used to collect data on health and household expenditure. Weights, heights, waist circumference and blood pressure measurements were taken for an adult and one child (6-16 years) from each household.
  
  
  RESULTS
  Amongst adults, there was no difference in the prevalence of pre-hypertension and hypertension. More male (68.1% vs. 47.8%) and female beneficiaries (84.5% vs. 77.9%) were overweight/obese. More male (17.2% vs. 7.1%; P < 0.05) and female beneficiaries (68.5% vs. 63.3%; P < 0.05) exhibited substantially increased risk for CVD. Children of beneficiaries displayed higher mean BMI-for-age z-scores than their control peers: males 0.56 [95% CI 0.40-0.72] vs. 0.18 [95% CI 0.02-0.35] (P < 0.001) and females 0.66 [95% CI 0.52-0.80] vs. 0.42 [95% CI 0.29-0.56] (P < 0.001). Based on BMI-for-age z-scores, children of beneficiaries had greater odds of being overweight/obese (OR = 1.46; 95% CI 1.18-1.82) Beneficiaries were economically better off; their mean total annual expenditure and house ownership were significantly higher than controls (P < 0.001).
  
  
  CONCLUSIONS
  Microcredit financing is positively associated with wealth acquisition but worsened cardiovascular risk status.
authors.affiliation: Mona Office for Research and Innovation, University of the West Indies, Mona, Jamaica.
authors.forename: Georgiana
authors.initials: G
authors.lastname: Gordon-Strachan
authors.forename: Colette
authors.initials: C
authors.lastname: Cunningham-Myrie
authors.forename: Kristin
authors.initials: K
authors.lastname: Fox
authors.forename: Claremont
authors.initials: C
authors.lastname: Kirton
authors.forename: Raphael
authors.initials: R
authors.lastname: Fraser
authors.forename: Georgia
authors.initials: G
authors.lastname: McLeod
authors.forename: Terrence
authors.initials: T
authors.lastname: Forrester
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D005260:Female; D005381:Financing, Organized / Q000706:statistics & numerical data*; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D009765:Obesity / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: cardiovascular risk; community case control; comunidad caso control; concordance; contrôle de cas communautaire; health; matching; microcredit; microcrédit; microcrédito; pareamiento; riesgo cardiovascular; riqueza; risque cardiovasculaire; santé