The contribution of urbanization to non-communicable diseases: Evidence from 173 countries from 1980 to 2008 |
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| Institution: | 1. The Organisation for Economic Co-operation and Development, Paris, France;2. Department of Economics and Management, University of Padova, Padova, Italy;3. Centre for Health Economics, University of York, York, United Kingdom;1. Division of Cardiology, University of Washington, Seattle, WA, USA;2. Division of General Medicine, Columbia University, New York, NY, USA;1. The Hatter Institute for Cardiovascular Research, Department of Medicine, Faculty of Health Sciences, The University of Cape Town, Cape Town, South Africa;2. Department of Cardiovascular Medicine, Muhimbili National Hospital, Tanzania;3. Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique;1. Halberg Hospital and Research Institute, Moradabad, Uttar Pradesh, India;2. Graduate School of Health Sciences, Fukuoka Women’s University, Fukuoka, Japan;3. The Rohto Pharmaceutical Co. Ltd, Osaka, Japan;4. Department of Health Promotion Sciences, Health Sciences Center, Osaka, Japan;5. Faculty of Medicine, PJ Safaric University, Kosice, Slovakia;6. University of Arkansas for Medical Sciences, Little Rock, AR, United States;1. Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Córdoba, CONICET, Facultad de Ciencias Médicas, Av. Enrique Barros y Enfermera Gordillo, CP 5016, Córdoba, Argentina;2. Centro de Investigación y Estudios en Cultura y Sociedad (CIECS), Universidad Nacional de Córdoba, CONICET, Rondeau 467 Piso 1, CP 5000, Córdoba, Argentina;3. Asociación Ecuatoriana de Estudios de Población, ADAMA, Universidad Nacional de Córdoba, Av. Vélez Sarsfield 153 Barrio Centro, CP 5000, Córdoba, Argentina;4. Departamento de Matemática y Estadística, Facultad de Ciencias Económicas, Universidad Nacional de Córdoba, Av. Valparaíso s/n, CP 5016, Córdoba, Argentina;5. Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Av. Enrique Barros s/n, CP 5016, Córdoba, Argentina |
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| Abstract: | It is widely believed that the expanding burden of non-communicable diseases (NCDs) is in no small part the result of major macro-level determinants. We use a large amount of new data, to explore in particular the role played by urbanization – the process of the population shifting from rural to urban areas within countries – in affecting four important drivers of NCDs world-wide: diabetes prevalence, as well as average body mass index (BMI), total cholesterol level and systolic blood pressure. Urbanization is seen by many as a double-edged sword: while its beneficial economic effects are widely acknowledged, it is commonly alleged to produce adverse side effects for NCD-related health outcomes. In this paper we submit this hypothesis to extensive empirical scrutiny, covering a global set of countries from 1980–2008, and applying a range of estimation procedures. Our results indicate that urbanization appears to have contributed to an increase in average BMI and cholesterol levels: the implied difference in average total cholesterol between the most and the least urbanized countries is 0.40 mmol/L, while people living in the least urbanized countries are also expected to have an up to 2.3 kg/m2 lower BMI than in the most urbanized ones. Moreover, the least urbanized countries are expected to have an up to 3.2 p.p. lower prevalence of diabetes among women. This association is also much stronger in the low and middle-income countries, and is likely to be mediated by energy intake-related variables, such as calorie and fat supply per capita. |
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| Keywords: | Non-communicable diseases Hypertension Cholesterol Diabetes BMI Urbanization |
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