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McLaren, Shawn (2021) Iron status and socio-economic indicators among women of childbearing age in South Africa: a secondary analysis of DHS data. Ecology of Food and Nutrition. ISSN 0367-0244
Introduction:
The nutritional double burden of disease refers to the phenomenon of undernutrition, wasting, stunting, micronutrient deficiency coinciding with overweight, obesity, and diet-related non-communicable diseases, within individuals, households and populations throughout the lifecycle.
Objectives:
This study aimed to determine whether there were differences in haemoglobin levels between anthropometric categories and socio-economic factors among women aged 16 to 45 years old in South Africa.
Methods:
Data was obtained from the DHS South Africa survey 2016. There were 2662 women between 16 and 49 years old included in the sample. Variables selected for analysis included, height and weight haemoglobin adjusted for altitude, wealth index and access to improved water and sanitation. Variables were tested for normality using Q-Q plots. Frequencies and percentages were reported for categorical data. Non-parametric continuous variables were reported as medians and interquartile ranges. As data was not normally distributed, analysis was conducted using the Kruskall-Wallis test and Mann-Whitney U test. The type I error rate was set to p<0.05. Where it was found that a significant difference exists, post hoc Dunn tests were performed to determine the location of the differences.
Results:
Anaemia was prevalent among 30.7% of the sample and 61.8% were either overweight or obese. Haemoglobin levels were significantly different between normal weight women and women with a body mass index in the obese class I and obese class II categories respectively (Kruskall-Wallis =10.992; 4df; p=0.027). There were significant differences in haemoglobin levels between women with access to improved sanitation and those without access (Mann-Whitney U test p=0.038; n=2662), but haemoglobin levels were similar between women with access to improved water and those without (Mann-Whitney U test p=0.685; n=2662). Poorer women had significantly different haemoglobin levels to the wealthiest women in the sample.
Conclusion:
The nutritional double burden of disease is present in South Africa among women of childbearing age. A wealth disparity exists among South African women in terms of haemoglobin levels.
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