Diets, Nutrition, and Poverty - The Oxford Topic of Food, Politics, and Society - page 342

9% and a little less than 2%, respectively; among the Scheduled Tribes, the proportions
were slightly lower—about 6% and above 1%, respectively; among the Other Backward
Castes (OBCs), the corresponding estimates were above 12% and about 3%, respectively;
and among the remaining, the estimates were the highest—above 17% and about 5%,
respectively. Finally, there was a sharp increase in the proportions of the overweight and
obese over the period from 1998 to 2005. The proportion of the overweight more than
tripled, whereas that of the obese rose at least six times.
Let us briefly consider the subset of households that contain both underweight children
(< age 5) and obese adults—or the double burden of malnutrition. Although their share was
low—about 3.3% in the aggregate sample—it varied slightly between the poor and nonpoor
(2.35% and 3.75%, respectively). In a more disaggregated monthly per capita expenditure
classification (<Rs 300, Rs 300-500, Rs 500-1000, and >Rs 1000), there was, however, a
clear progression, with the obesity rate rising from 2.85% to 6.5%. In the urban areas and
urban slums, the rate (about 4.86%) was almost twice as high as in the rural areas (2.75%).
As a recent article in The Economist (2012) observes, India has an obesity epidemic in
cities, as people eat more processed food and adopt more sedentary lifestyles. And with
obesity, the risk of NCDs (diabetes and heart diseases) rises. Our findings on the corre-
lates of NCDs are summarized next.
In all four cases—prevalence of high blood pressure, heart disease, diabetes, and can-
cer—the majority suffering from these diseases were in the older age group (i.e., above
45 years). Among those reported to be suffering from high BP and heart diseases, the
majority were females. In the case of diabetes and cancer, the majority were males.
A vast majority of those suffering from high blood pressure (90%), heart diseases (90%),
diabetes (93%) and cancer (83%) were nonpoor. What further corroborates the role of
affluence is that, in the more detailed expenditure classification, the proportion suffer-
ing from NCDs rises with expenditure interval. For example, the proportion of those
suffering from high blood pressure rises from 11% in the lowest expenditure interval
(<Rs 300 per capita per month) to over 36% in the highest interval (>Rs 1000 per capita
per month). In the case of heart disease, the prevalence rate was considerably higher in
the highest expenditure interval (over four times that in the lowest). Although a major-
ity of those suffering from high blood pressure (39%) were in urban areas, a majority of
those suffering from heart diseases (51%), diabetes (54%), and cancer (75%) were in rural
areas. About 43% of the obese reported to be suffering from high BP. The corresponding
numbers for heart disease and diabetes are 13% and 25%, respectively.
Our econometric analysis focuses on determinants of average prevalence of NCDs
(i.e., number of household members suffering from high blood pressure or heart disease
or diabetes or cancer/household size). The highest elasticity is associated with age; the
next highest with respect to per capita expenditure; and much lower is the elasticity with
respect to overweight/obese adults42; metros display slightly higher prevalence, com-
pared to the remaining urban areas.
One obvious policy imperative is to avert the specter of growing disabilities and
deaths due to NCDs, through awareness building of healthy food choices and physically
active lifestyles.43