The Social Determinants of Health: Globalization, Urbanization, and Overweight in the Southern African Development Community

Africa is facing the dual challenge of under-nutrition and a growing burden of overweight and obesity especially in countries that are urbanizing and globalizing fast. The WHO Commission on Social Determinants of Health framework is used to study the confluence of urbanization and wealth and their links with overweight and obesity in the Southern African Development Community (SADC). The region has some of the highest rates of obesity, but also high rates of malnutrition among children. DHS Data, along with other macro-level statistics from UN agencies were used to identify the determinants of overweight or obesity among women. 9 out of 15 countries have overweight or obesity prevalence of more than 30% among adult women. The country results show that age, educational level, household wealth, marital status, and contraceptive use are associated with the odds of being overweight or obese. The interaction between urban/rural place of residence and household wealth status shows three patterns: high overweight levels in urban compared with rural areas for the poorer countries; no difference between urban and rural levels where the national prevalence of overweight or obesity is very high; and a cross-over effect in the wealthier countries where the rural affluent women have the highest levels of overweight or obesity.