The contribution of urbanization to non-communicable diseases: evidence from 173 countries from 1980 to 2008

TY - JOUR

T1 - The contribution of urbanization to non-communicable diseases

T2 - evidence from 173 countries from 1980 to 2008

AU - Goryakin, Yevgeniy

AU - Rocco, Lorenzo

AU - Suhrcke, Marc Eckart

N1 - © Elsevier, 2017. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy

PY - 2017/8

Y1 - 2017/8

N2 - 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.

AB - 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.

KW - BMI

KW - Cholesterol

KW - Diabetes

KW - Hypertension

KW - Non-communicable diseases

KW - Urbanization

UR - http://www.scopus.com/inward/record.url?scp=85017388053&partnerID=8YFLogxK

U2 - 10.1016/j.ehb.2017.03.004

DO - 10.1016/j.ehb.2017.03.004

M3 - Article

SN - 1570-677X

VL - 26

SP - 151

EP - 163

JO - Economics and Human Biology

JF - Economics and Human Biology

ER -