Navegando por Autor "Yamada, Goro"
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Item Are women’s empowerment and income inequality associated with excess weight in Latin American Cities?(2022) Tumas, Natalia; Rodríguez López, Santiago; Mazariegos, Mónica; Ortigoza, Ana; Anza Ramírez, Cecilia; Pérez Ferrer, Carolina; Moore, Kari; Yamada, Goro; Menezes, Mariana Carvalho de; Sarmiento Dueñas, Olga Lucia; Pericàs Pulido, Juan Manuel; Costes, Francesc Belvis; Lazo, Mariana; Benach, JoanWhile income gradients and gender inequalities in excess weight have been noted elsewhere, data from Latin American cities is lacking. We analyzed gender-specifc associations between city-level women’s empowerment and income inequality with individual-level overweight/obesity, assessing how these associations vary by individual education or living conditions within cities in Latin America. Data came from national surveys and censuses, and was compiled by the SALURBAL project (Urban Health in Latin America). The sample included 79,422 individuals (58.0% women), living in 538 sub-cities, 187 cities, and 8 countries. We used gender-stratifed Poisson multilevel models to estimate the Prevalence Rate Ratios (PRR) for overweight/obesity (body mass index≥25 kg/m2 ) per a unit change in city-level women’s empowerment (proxied by a score that measures gender inequalities in employment and education) and income inequality (proxied by income-based Gini coefcient). We also tested whether individual education or sub-city living conditions modifed such associations. Higher city labor women’s empowerment (in women) and higher city Gini coefcient (in men) were associated with a lower prevalence of overweight/obesity (PRR=0.97 (95%CI 0.94, 0.99) and PRR=0.94 (95%CI 0.90, 0.97), respectively). The associations varied by individual education and sub-city living conditions. For labor women’s empowerment, we observed weakened associations towards the null efect in women with lower education and in residents of sub-cities with worse living conditions (men and women). For the Gini coefcient, the association was stronger among men with primary education, and a negative association was observed in women with primary education. Our fndings highlight the need for promoting equity-based policies and interventions to tackle the high prevalence of excess weight in Latin American cities.Item Racial inequities in self-rated health across Brazilian cities : does residential segregation play a role?(2022) Guimarães, Joanna Miguez Nery; Yamada, Goro; Barber, Sharrelle; Caiaffa, Waleska Teixeira; Friche, Amélia Augusta de Lima; Menezes, Mariana Carvalho de; Santos, Gervasio; Santos, Isabel; Cardoso, Leticia de Oliveira; Roux, Ana V. DiezRacial health inequities may be partially explained by area-level factors such as residential segregation. In this cross-sectional study, using a large, multiracial, representative sample of Brazilian adults (n = 37,009 individuals in the 27 state capitals; National Health Survey (Pesquisa Nacional de Saúde), 2013), we investigated 1) whether individual-level self-rated health (SRH) (fair or poor vs. good or better) varies by race (self-declared White, Brown, or Black) and 2) whether city-level economic or racial residential segregation (using dissimilarity index values in tertiles: low, medium, and high) interacts with race, increasing racial inequities in SRH. Prevalence of fair or poor SRH was 31.5% (Black, Brown, and White people: 36.4%, 34.0%, and 27.3%, respectively). Marginal standardization based on multilevel logistic regression models, adjusted for age, gender, and education, showed that Black and Brown people had, respectively, 20% and 10% higher prevalence of fair or poor SRH than did White people. Furthermore, residential segregation interacted with race such that the more segregated a city, the greater the racial gap among Black, Brown, and White people in fair or poor SRH for both income and race segregation. Policies to reduce racial inequities may need to address residential segregation and its consequences for health.