title: Associations Between Orphan and Vulnerable Child Caregiving, Household Wealth Disparities, and Women's Overweight Status in Three Southern African Countries Participating in Demographic Health Surveys.
abstract: This study examines whether orphan and vulnerable children (OVC) primary caregivers are facing absolute household wealth (AWI) disparities, the association between AWI and women's overweight status, and the modifying role of OVC primary caregiving status on this relationship. Demographic Health Surveys data (2006-2007) from 20 to 49 year old women in Namibia (n = 6,305), Swaziland (n = 2,786), and Zambia (n = 4,389) were analyzed using weighted marginal means and logistic regressions. OVC primary caregivers in Namibia and Swaziland had a lower mean AWI than other women in the same country. In Zambia, OVC primary caregivers had a lower mean AWI score than non-primary caregivers living with an OVC but a higher mean AWI score than non-OVC primary caregivers. In Swaziland and Zambia, even small increases in household wealth were associated with higher odds for being overweight regardless of women's caregiving status. Only in Namibia, OVC primary caregiving modified the effect of the previous association. Among Namibian OVC primary caregivers, women who had at least medium household wealth (4 or more AWI items) were more likely to be overweight than their poorest counterparts (0 or 1 AWI items). OVC primary caregivers are facing household wealth disparities as compared to other women from their communities. Future studies/interventions should consider using population-based approaches to reach women from every household wealth level to curb overweight in Swaziland and Zambia and to focus on specific household wealth characteristics that are associated with OVC primary caregivers' overweight status in Namibia.
authors: Center for Research on U.S. Latinos HIV/AIDS and Drug Use, Florida International University, 11200 SW 8th ST PCA 353A, Miami, FL, 33199, USA, mkanamor@fiu.edu.
authors: Mariano J
authors: MJ
authors: Kanamori
authors: Olivia D
authors: OD
authors: Carter-Pokras
authors: Sangeetha
authors: S
authors: Madhavan
authors: Sunmin
authors: S
authors: Lee
authors: Xin
authors: X
authors: He
authors: Robert H
authors: RH
authors: Feldman
mesh_terms: D000328:Adult; D017954:Africa South of the Sahara; D017028:Caregivers / Q000706:statistics & numerical data*; D002648:Child; D054540:Child, Orphaned; D003430:Cross-Sectional Studies; D013541:Eswatini / Q000453:epidemiology; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007182:Income; D016015:Logistic Models; D008875:Middle Aged; D009276:Namibia / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology*; D011203:Poverty; D012111:Residence Characteristics; D012959:Socioeconomic Factors; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D015024:Zambia / Q000453:epidemiology
references: AIDS. 2000;14 Suppl 3:S275-84
references: 11086871
references: Demography. 2001 Feb;38(1):115-32
references: 11227840
references: Clin Exp Pharmacol Physiol Suppl. 2002 Oct;(29):S23-6
references: 12355911
references: Gerontologist. 2003 Apr;43(2):230-41
references: 12677080
references: J Epidemiol Community Health. 2004 Jan;58(1):71-7
references: 14684730
references: J Health Popul Nutr. 2003 Sep;21(3):235-42
references: 14717569
references: Soc Sci Med. 2005 Aug;61(3):697-708
references: 15899327
references: West J Nurs Res. 2006 Jun;28(4):369-82; discussion 383-91
references: 16672629
references: Am J Public Health. 2006 Aug;96(8):1429-35
references: 16809585
references: Obes Rev. 2006 Nov;7(4):315-22
references: 17038125
references: Health Policy Plan. 2006 Nov;21(6):459-68
references: 17030551
references: Obesity (Silver Spring). 2007 Aug;15(8):2111-9
references: 17712130
references: Ann Hum Biol. 2008 Mar-Apr;35(2):232-49
references: 18428015
references: J Transcult Nurs. 2009 Jan;20(1):61-8
references: 18852478
references: FAO Food Nutr Pap. 2006;84:1-334
references: 19172986
references: Econ Hum Biol. 2010 Dec;8(3):346-60
references: 20934394
references: Int J Obes (Lond). 2012 Aug;36(8):1114-20
references: 21912397
references: Public Health Nutr. 2011 Dec;14(12):2260-7
references: 21806869
references: Health Promot Int. 2013 Mar;28(1):4-16
references: 22933446
references: Obes Rev. 2013 Oct;14(10):806-17
references: 23782957
references: Int J Obes (Lond). 2014 Jan;38(1):97-105
references: 23649471