http://doi.org/10.33698/NRF0047  Baljit Kaur, KC. Kaistha

Body mass index and selected background characteristics :a study among females of a low socio –economic community

Baljit kaur, KC. Kaistha

Abstract : A  descriptive cross-sectional study was done to find the relation of selected background characteristics with the body mass index (BMI) of females residing in low socio economics commonly .the main research question was whether  there is any variation in the BMI of respondents with varied background characteristics in four randomly selected low socio-economic communities of Chandigarh .the respondents comprised  of females in the age group of 10-24 years in these communities .the findings  revealed that out of a total of 386 respondents ,69.7% were under weight as per WHO criteria .only 1.8% were overweight ,thereby  leaving less than one –third (28.5%) normal nourished as per BMI ,a significant relationship was found with age, marital status ,household size ,migration status ,socio-economic status and per capita income. the study had shown some contrary results as compared to recently conducted national family health survey (NFHS) .

 

Key Words:  Nutrition, Body Mass Index ,background characteristics ,low socio economic communities

Introduction :Nurses are concerned about the nutritional status of all their clients .nutrition is one of many indicators ,which have a bearing on every aspect of health right from conception through old age ,including fertility .in the global campaign of health for all ,promotion of proper nutrition is one of the eight elements of primary health care. nutrition is considered a cornerstone of socio-economic development in recent year .the assessment of the nutritional status may involve various techniques e.g. clinical examination ,anthropometry ,biochemical  evaluation ,assessment of dietary intake ,vital and health statistics and ecological studies.1 keeping inview ,the restriction of time .technical support and other resources ,anthropometry measurements involving height and weight of the respondents was selected to assess their Body Mass index (BMI) ,which has been used in recently conducted NFHS,2 At The National Level too. BMI  is Defined As,“the weight of an individual per square meter of his/her body.’’ The BMI is also known as `quetlet index,.3 the formula for its calculation is:

BMI  (Quetelet index)  =  weight (kg)   Height2 (m)

As per WHO3,the following criteria has been used to classify the respondents ,according to their BMI range:

Under-weight                        <   18.5     BMI

Normal –weight                   18.5-24.9 BMI

Over –weight                        >  24.9      BMI

 Materials and methods

Research design :  the present study is descriptive and cross –sectional in nature .it incorporates both quantitative and qualitative research methods.

Research setting:   Chandigarh is a modal of architectural grandeur in modern India, which is named after the local presiding deity `chandi ‘  -the goddess of power .Le-carbusier –the French architect planned Chandigarh .for a finite population of half a million ; 1,50,000 in phase –I in section 1 to 30 and 3,50,000 in phase –II in sectors 31to 47. Scholars have indicated that the negation of some of the basic objectives of Chandigarh ’ s master plan began from the very start of its construction .obviously ,the majority of those who were the first to arrive at the site were construction workers, with no provision for housing at all. Failure was evident ,by not making any provision for such workers (approximately 30,000) in the Chandigarh project estimates .consequently large clusters of thatched huts adjoining major construction work started   sprouting and thus began the genesis of the slums.4   the union territory of Chandigarh comprises of 47 sectors ,27 villages and 43 colonies .these colonies are slum dwellings with a population of approximately three lacs. As already started ,the dwellers of these slums are migrants majority of whom have migrated in the search of better job prospects .about 64 percent of these people are from states with very high morbidity and mortality indices (BIMARU States Viz .Bihar ,Madhya Pradesh ,Andhra Pradesh ,Rajasthan ,Uttar Pradesh and Orissa)

In comparison to general indices of india.there are approximately 55670 households with approximate population of 3 lacs.4

Target population :the target population consisted of all the females aged 10 to 24 years residing in the 43 colonies .

Sample selection : multi –stage sampling technique was used and a total of 410 respondents were selected from four colonies as show in table-I.

Table1 : sample size of the selected slums

Slum Number of households Total segments Segments selected House holds /segment Sample size (intended)
Daddu majra

Colony

2584 10 5 257 102
Janta colony 2726 12 6 227 118
Gur sagar

Sahib colony

456 2 1 228 50
Kajheri

Colony

3727 16 8 232 140
Total 9493 40 20 944 410

Final sample :  though it was intended to take up 410 study subjects ,only 386 females participated .twenty –four  subjects could not participate in the study due to various reasons.

Study tools and techniques : the interview schedule was deigned to collect information pertinent to various background characteristics i.e. age, educational status ,marital status ,type of family ,household size, caste religion ,working status ,migration status, socioeconomic status, per capita income etc. a standardized adult weighing machine and an inch tape was used to measure weight and height of the subjects respectively.

Results and discussion :The variables for these characteristics included are age  ,literacy ,religion ,caste ,type of family, family size ,working status of the respondent ,occupation of head of the family, total family income and per capita income of the respondents. All these directly or indirectly affect one’s health e.g. if an individual is educated, his/her attitude and perceptions will be different from the one who is illiterate and who may take the diseases as an evil cause or punishment by god. Similarly the income of a person may make her spend more on nutrition or health aspects than the one, who does not have enough to meet two ends. Table -2 exhibits the socio –demographic profile of the respondents .as is evident, the age of the respondents ranged from 10 to 24 years with a S. D. of ± 4.2 ,and a mean of 17.97 .about one fourth of them (27.4%) were in the age group of 22 to 24 years and 12 percent were in the age range of 10 to 12 years. educational qualification has come to be accepted as an important criterion for an individual ,to be positively inclined towards development .less than half (43%) were identified as illiterate ,while very few (4.2%) had an education upto class ten. The mean education calculated was only 3.8 school years .as per 1991 census of  Chandigarh ,60.8 percent of the females were identified to

Table -2 : socio –demographic profile of the respondents

Socio –Demographic Variable          Number of Respondents (%)              Mean : T.S.D .(Range)
 Age in year

10-12                                                             47(12.2)

13-15                                                             77(19.9)

16-18                                                             82 (21.2)                                                         17.97±4.2

19-21                                                            75 (19.3)                                                         (10-24)

22-24                                                            105 (27.4)

 

Literacy level

llliterate                                                        166 (43.0)

1-5th  class                                                    95 (24.6)

6-10th  class                                                 109 (28.2)

>10th class                                                      16(04.2)

Religion

Hindu                                                            344(89.1)

Muslim                                                          21 (05.4)

Sikh                                                               15(03.9)

Christian                                                         6(01.6)

Caste

Schedule caste                                               319 (82.6)

General caste                                                   42(10.9)

No caste                                                          25 (06.5)

Marital status

Never married                                                  189 (48.9)

Currently married                                             194 (50.3)

Widow/divorced                                                 3(0.8)

Type of family

Nuclear                                                           287(74.4)

Joint                                                                99 (25.6)

Family size

1-4                                                                   131 (33.9)

5-8                                                                   231 (59.8)

9-12                                                                  20 (05.20

>12                                                                    4(01.10

 

 Be literate .the present study shows the female literacy level is slightly lower (57%) , probably due to the reason that the slum dwellers are not much interested in educating their children especially the girl child. The most common religion , was Hinduism (89.1%) Followed by Islam , Sikhism , and Christianity in that order. This is slightly higher in case of  Hindus and slightly lower in case of others as in NFHS-2but keeping in mind that the northern states of India are mainly comprised of Hindus ,it is  ,it is therefore natural .it could be due to the fact that most of the respondent’s families had migrated from states ,which are Hindu dominated like utter Pradesh ,Haryana ,etc. since the slum dwellers are mostly employed as sweepers ,peons ,laborers, etc. scheduled castes ,were a majority caste, whereas, only 10.9 percent ,belonged to general caste, were a majority caste, whereas, only 10.9 percent ,belonged to general caste. the Chandigarh census (1991) presents 16.7 percent of the population as scheduled caste ,whereas in the present study 82.6 percent were found to belong to the scheduled caste ,whereas in the population as scheduled caste ,whereas in the present study 82.6 percent were found to belong to the scheduled caste category .almost half of the  respondents (48.9%)  were never married . three subjects were either widowed or divorced .in the subsequent analysis, this will be clubbed along with the married and will be tanned as ever married, due to their negligible number. The predominant type of family was the nuclear family, as is expected in these slums .almost three-fourth ,of the respondents were living in nuclear families, while one-fourth were from joint families .the family size ranged from 1 to 19 family members in a family. The mean size of family was 5.38 with a S.D. of 2.29 .the mean household size is almost the same (5.4) as for all India by NFHS-2.

Occupation and income of a person obviously reflects the economic status of a person .occupation refers to a set of activities ,which a person performs in order to earn livelihood .it is an important indicator of a person’s position and status in the society .income is invariably related to occupation .table-3 shows that 75 percent of the respondents were not working .they were either housewives or students and about  16.3 percent had left studies or did not study at all and were just helping in household chores .these were the unmarried girls ,hence they could not be termed as housewives. among the working class, majority(19.9%)of the total 25 percent were working  as maidservants. As far as the income is concerned leaving aside 75 percent of the respondents ,who were non-workers ,most of them (13.3%) earned in the range of rs.301-600 per month. Only 5.2 percent earned more than Rs. 900 per month. since majority were not earning ,the mean income was Rs.153.1 with almost double S.D. of 299.5 with a range of 0 to 1500 (table-4) The respondents were distributed into three socio- economic status classes –        I,II and III .these were made taking into consideration five characteristics of the respondents corresponding to their dwelling unit indes, dwelling unit utilities, house  –

 

 

 

 

 

 

 

 

Table-3: distribution of the respondents as per their occupation and personal income

                                                                                                                                 (N=386)

Variable                                       number of respondents (%)                                   mean±S.D .(Range)
Occupation

Housewife                                              134(34.7)

Student                                                     93(24.1)

Unemployed                                             63(16.3)

Maid servant (PC* -V)                              77(19.9)

Rag Picker (PC- VI)                                 6(01.6)

Tailor (PC-III)                                          5 (01.3)

Road –side hawker (PC-IV)                     4(01.0)

Shopkeeper (PC-II)                                   3 (0.8)

TEACHER (PC-I)                                    1(0.3)

Income / month (in Rs.)

Nil                                                        290(75.0)

1-300                                                      12(3.1)

301-600                                                  51 (13.3)                                                     153±299.5

601-900                                                  13(3.4)

901-1200                                             19(4.9)                                                               (0-1500)

>1200                                                      1(0.3)

 

*prestigious category

Table -4: distribution of respondents according to the per capita income of the family

                                                                                                                                               (N=386)

 Per capita income (in Rs.)                         Number of respondents (%)                 mean ±S.D.(Range
           1-500                                                         110(28.5)

501-1000                                                 166(43.0)                                               890±559.7

1001-1500                                                 70(18.1)                                                 (167-5333)

1501-2000                                                26(6.7)

>2000                                                       14(3.6)

Assets, Personal Status and the status of the head of the family .as os evident from table-5,almost 47.4 percent comprised class-II followed by 27.2 percent of class – III and 25.4 percent class-I .thus classes-I .Thus ,these classes-I,II and  III ,can be termed as the richer among the poorer ,middle class among the poorer and the poorest of the poore ,respectively. Overall the slum people are usually included in the poorer strata of the society.

Table -5: Distribution of respondents according to their socio economic status

(N=386)

Socio –economic status                                                                                   Number of respondents(%)
High –I                                                                                                                              98(25.4)

Medium –II                                                                                                                        183 (47.4)

Low –III                                                                                                                              105 (27.2)

 

 

As is evident from table-6 shows that majority (69.7%)of the respondents were undernourished with BMI of less than 18.5 .about twenty nine percent had normal BMI and only 1.8 percent had normal BMI and only 1.8 Percent respondents were found to be overweight .as per the studies 10-20 percent of children and adolescents are obese at this age .but as expected, slum dwellers do not give proper attention to their nourishment ,either due to lack of knowledge or due  to poverty .the range of BMI of respondents was from 8.67 to 31.04.the mean BMI of 16.97 is much less than the 19.3 of NFHS-2 corresponding to the same age group of the respondents .the percentage of women with BMI less than 18.5 as per NFHS-2 was only 40.3 percent compared to 69.7 percent for the present sample.

Table -6: distribution of respondents according to their body mass index  

                                                                                                                                           (N=386)

 

BMI range           nourishment status                  number of respondents (%)          mean±S.D.(range)
<18.5                            underweight                                        269(69.7)                                   16.97 +3.68

18.5-24.9                      normal weight                                       110(28.5)                                 (8.67-31.04)

>24.9                              overweight                                              7(1.8)

Table7,brings to the fore ,the body mass index of the respondents with reference to selected background characteristics.

Age: it can be seen that the percentage of the respondents who are undernourished decreases as the age increases. hence, highest percentage (100%) is found among 10-12 year girls ,while lowest (40.9%) are among the 22-24 years age group .moreover ,other ranges of BMI increased as the age increased ,thus the obese respondents were found only in the two highest age-group .the differences found have been highly significant. An inverse relationship has been found between age and undernourishment .the reason could be that younger girls are dependent for food on their parents .the culture of giving less diet to girls ,eating in the end when everyone else (especially the males ) had taken their meals ,could be the reason for this undernourishment among younger age group .on the other hand, the older age group who are independent ,and majority being married ,are found to have a comparatively better BMI status .this may be because they had access to the food being cooked, and subsequently consumed by them.

Education status: There was no obvious effect of education on the BMI status of the respondents,

Which was statistically insignificant.

Marital status: The unmarried girls usually have a lower BMI than the married girls, which is again statistically significant .the probable reason here too could be that the married women cook themselves and thus have access to food ,while the unmarried could be dependent on their parents, especially mothers .since age and marital status have a positive relationship therefore as the girls get older and get married ,they tend to have a better BMI.

Type of family: No obvious effect of type of family was found on BMI status of the respondents.

Household size  : the household size too had a significant difference on the BMI status of the respondents .it was interesting to observe that all the obese women were found in those  families ,where the number of family members was less . in bigger households ,there was less. In bigger households ,there was no difference in under –weight and normal –weight respondents .none of the obese women were found in large households .the obvious reason could be that a smaller is the family more is to eat while a bigger family had lesser to eat.

Caste and religion: There was no significant difference of BMI  status among the various castes and religions .since ,there were very few respondents from non-schedule caste and other religions than Hindus ,the results may not be generalized and further exploration is needed.

Working status: There is a common belief that since working women  have more access to food so they  are better nourished .but in the present study ,the  working status of the respondent did not have any effect on her BMI status .there was no significant difference between the working and non-working respondents.

Migration status :it was observed that the respondents who had migrated had comparatively a lesser percentage of undernourished women ,than those who were non migrants .the number of obese respondents was also more among the migrants ,which was statistically significant the reason for this could be that the migrants had migrated for employment ,and all of them might be earning ,while the non-migrants had been living here for long and some of them could be unemployed .thus migrants had access to better nourishment .

Socio-economic status:  it was a very interesting observation ,that socio-economic status and BMI have an inverse relationship ,which is contrary to the common belief that people with higher socio-economic status will have enough to eat so will have normal BMI status .it was seen that as the socio-economic status decreases BMI increases among the respondents ,which is statistically significant .none of the obese respondents were found in higher socio-economic status class.

Per capita income: since cross –tabulation with socio-economic status of the respondents was made to relate BMI with per capita income of the family members. Here too, the results were almost similar .the respondents with lower per capita income had both more under-weight and over –weight respondents ,than the normal weight ,though number of under –weight respondents decreased as the per capita income of the family increased .the results were statistically significant .this study shows little bit different results where BMI as a measure of nutritional status is examined in relation to various background  characteristics of the respondents .NFHS-2 ,indicated a high prevalence of  nutritional deficiency with below 18.5 BMI  ,particularly serious for women in rural, illiterate ,women from other religions ,schedule caste and schedule tribe ,women who are not self employed and who live in households with a low standard of living .contrary was made in relation to socio-economic status ,migration status and working status of the respondents .though similarity with age, marital status ,educational status and household size  could be established in comparison to NFHS-2 data .the probable reason for this could be the special nature of population selected for the present study .the NFHS data is representative of all types of population viz. rural ,urban ,lower and upper castes ,while for this study only slums had been chosen .thus further exploration ,at some other occasion is needed and one needs to explore deeper to know why it has occurred .

Conclusions

Seventy percent of the respondents were undernourished as per WHO classification of Body Mass index (BMI) and only 2 percent were found to be obese. The mean BMI was 16.97,which is much less than the lower limit of normal  BMI as per who i.e. 18.5 .An inverse relationship was observed in undernourishment and age marital status ,type of family, migration status and per capita income of the family Working Status

 

Of the respondent, religion, caste, household size and educational stat had no obvious effect on the nourishment status. Some of these results are contrary to NFHS-2 data, may be because of the special nature of population of this present study.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table-7 : body mass index and selected background characteristics

Background               body mass index                                              total number                         significance

Characteristics               <18.5                  18.5-24.9            >24.91     of respondents                         level

 Age in year

10-12                               47(12.2)                    0                         0                   47

13-15                               69(89.6)                 8(10.4)                   0                  77                                 x2=83.139*

16-18                               64(78.1)                 18(21.9)                 0                  82                                    df.=8

19-21                               46(61.3)                  27(36.0)             2(2.7)              75

22-24                               43(40.9)                  57(54.3)             5(4.8)             105

 

Educational status

llliterate                          107(64.5)              55(33.1)                 4(2.4)              166                       x2=10.051

1-5th  class                       77(81.1)                17(17.8)                 1(1.1)               95                           df=6

6-10th  class                    76(69.6)                31(28.4)                2(1.8)              109

>10th class                       9(56.3)                  7(43.7)                     0                    16

Marital status                  

Never married            162 (85.7)               27(14.3)                  0                    189                        x2 =47.794*

Ever married                107(54.3)                83  (42.1)                7(3.6)             197                            df.=2

Type of family          

Nuclear                       204 (71.1)             79 (27.5)                 4(1.40)              287                       x2= 1.768

Joint                            65(65.7)                31(31.3)                   3(3.0)                 99                          df.=2

Caste

Schedule caste              222(69.8)               91(28.6)                   5(1.6)               318                        x2 =592

Non SC                          47(69.2)                 19 (27.9)                 2(2.9)                68                          df=6

 

Religion

Hindu                            240(69.8)                99(28.9)                   5(1.3)                344                       x2=592

Other                              29(69.1)                  11(26.2)                   2(4.7)                42                        df.=2

 

Working Status     

Working                        67(69.8)                  27(28.1)                    2(2.1)                96                      x2=.058

Non-Working                202(69.7)                83(28.6)                    5(1.7)                290                     df.=2

Migration Status

Non-migrant                  113(77.9)                30(20.7)                    2(1.4)               145                    x2=7.473*

Migrant                            156(64.7)               80(33.2)                    5(2.1)               241                    df.=2

 

Socio-economic status

High                                80(81.6)                    18(18.4)                      0                    98                     x2=16.782*

Medium                           130 (71.0)                 49(26.8)                   4(2.2)              183                    df.=4

Low                                  59(56.2)                    43 (40.9)                 3(2.9)               105

Per capita income

1-500                               85(77.3)                 24 (29.8)                     1(0.9)                110

501-1000                         122(73.5)               41(24.7)                      3(1.8)                166                     x2=   16.782*

1001-1500                       41(58.6)                  26(37.1)                     3(4.3)                 70                       df.=4

1501-2000                       13(50.0)                   13(50.0)                      0                      26

>2000                               8(57.1)                     67(42.90)                    0                     14

 

*significant at 5% level

Thus the study needs to be replicated on a larger scale in the same type of population to universalize the results

 

References

  1. Park JE and  Park K.Park’s Textbook of preventive and Social Medicine .Jabalpur ,India : M/S Banarsi Das Bhariol,2003
  2. International Institute of Population Sciences (11PS) and ORS Marco.National Family Health Survey (NHFS-2) ,Mumbai ,India ,2000.
  3. WHO Obesity :Preventing and Managing global epidemic .WHO technical report series 894-200,1-20.
  4. Dubey VP,Kalla HL, Duggal B,Kaur R,Vrdhan R.Socio-economic profile of slum –dwellers in Chandigarh .Man and Development September 1991: 125-143.
  5. Census of Chandigarh .General Population tables AND PRIMARY census Abstract ,Part II-A ,Directorate of census operation ,Chandigarh.