Page 77 - IJPS-8-1

International Journal of
Population Studies Urbanization and body weight

to stem from urbanization, one of the most dramatically misleading because it may be largely driven by between-
changing features of communities in contemporary China community differences, including substantial pre-existing
(Monda et al., 2007; Monda et al., 2008; Xu et al., 2013). gaps in urbanization levels between rural and urban areas
In China, urbanization can be driven by flows of and an uneven pace of urbanization across the entire
migrants from rural villages to cities for better life country (Xie & Hannum, 1996; Yeh et al., 2011).
opportunities, resulting in rapid increases in population This study seeks to improve our understanding about
size and density in existing urban areas. Meanwhile, the overall association between urbanization and weight
rural villages can experience in situ urbanization fueled gain in Chinese adults by disaggregating it into two
by the development of township and village enterprises components: (1) the between-community component that
and the inflow of foreign investment. In-situ village captures differences in level of urbanization at baseline and
urbanization involves changes in the economic structure, rate of urbanization over time across communities; and (2)
wherein the labor force shifts from agricultural activities the within-community component that reflects the in situ
to activities in manufacturing and service sectors. In situ urbanization process and corresponds to the conventional
village urbanization also includes changes in the built theory of neighborhood effects on health (Roux, 2004;
environment, wherein previously rural areas of farmland Entwisle, 2007). Drawing on longitudinal and multilevel
and farmhouses are converted into urban areas with data from the CHNS, the present study prospectively
modern roads designed for automobiles, factories, and examines body weight changes in Chinese adults from
residential and commercial centers (Zhu, 2000; Zhu, 2002). 1991 to 2015. The analysis of weight change relies on
both general adiposity and abdominal adiposity with
In situ urbanization involves within-community physically measured anthropometric data, minimizing
longitudinal changes in demographics, socioeconomic simplistic erroneous inference that can result from sole
conditions, and built environment, while urbanization reliance on body weight measures (Xu et al., 2013). Two
through rural-to-urban migration can be seen as disaggregation methods are compared in assessing the
between-community cross-sectional differences in these relative strengths of between- and within-community
characteristics. Therefore, in situ urbanization is the context components in explaining the longitudinal association
often related to the conventional wisdom about the effects between urbanization and weight gain.
of changing community characteristics on individual-
level weight gain. That is, increasing in situ urbanization 2. Prior research and limitations
in China is thought to have a strong impact on altering An ongoing longitudinal panel study first conducted in
individual physical activity patterns in the urbanized 1989, the CHNS now includes more than 7000 households
areas, which, in turn, is thought to drive the increasing across 15 provinces and municipal cities in contemporary
prevalence of overweight and obesity in China (Monda China that vary substantially in geography, economic
et al., 2007; Monda et al., 2008). As part of the urbanization development, public resources, and health indicators. In
process, local food environment is also likely to shift, addition, detailed community-level data are collected from
usually from a high-fiber, low-fat, and low-energy diet to local officials. The long survey period makes the CHNS
a low-fiber, high-fat, and high-energy diet, contributing to data extremely valuable for studying the relation between
the so-called “obesogenic environments” – contexts that urbanization and body weight status, not only because it
promote obesity by encouraging both physical inactivity usually takes some time for community characteristics
and excessive energy intake (Swinburn et al., 1999; Mehta to evolve as a result of human activities but also because
& Chang, 2008). the study period of the CHNS (1990s and 2000s) is when
Investigation into the in situ urbanization process and China experienced unprecedented social changes and
its implications for within-community weight gain requires urbanization. Therefore, it is not surprising that previous
longitudinal data at both the individual and community research on community-level urbanization and weight
levels. The China Health and Nutrition Survey (CHNS) gain in China heavily relies on analyses of the CHNS data.
has been a valuable data source in this regard. However, That being said, a few studies using the CHNS data
as reviewed below, previous analyses of the CHNS data examined only cross-sectional associations between
focused on an overall association between community- urbanization and body weight status. For example, Van
level urbanization and individual-level body weight status de Poel et al. (2009) performed separate cross-sectional
without making either a conceptual or an analytical analyses of respondents aged 16 years and older from the
distinction between within-community urbanization 1991 and 2004 waves of CHNS. They found that, compared
processes and pre-existing between-community differences. with residents of communities in the bottom tercile of an
Thus, an observed overall association can be theoretically urbanicity index, the risk of being overweight (body mass

Volume 8 Issue 1 (2022) 71 https://doi.org/10.36922/ijps.v8i1.334