This dissertation investigates the effects of income, income growth and other determinants on the development of overweight and obesity in two transition countries, Russia and South Africa. The results are shown in Chapter 2 and Chapter 3. Chapter 4 examines regional
climate agreements by evaluating their type and dimension, their goals and compliance mechanisms, and their incentives and funding.
The studies on drivers of overweight and obesity provide evidence that excess body weight is influenced by long-term factors. In general, for both countries, for a set of socioeconomic variables, our findings are in accordance with previous research: Women are (relative to their height) heavier compared to men, age and living with a partner are positively associated with body weight, whereas physical activity and smoking are negatively associated with BMI.
Education is positively associated with rising BMIs in both countries, but for Russia we find that women with tertiary education have a significantly lower BMI compared to women with less than secondary education. Hence, education might be one channel to address high obesity rates. It seems to be clear – from both studies on Russia and South Africa – that income positively affects BMI. Hereby, different transmission channels play a role. For the case of South Africa, our findings suggests that a high BMI is still perceived as “healthy”
potentially because being thin in some people’s minds is related to HIV/AIDS (the “slim”
disease), a disease which heavily affects the South African society. Additionally, a visible high body weight still seems to be perceived as a sign of wealth and power which supports the assumption that it is the preferred body status. For the case of Russia we establish that the rise of prevalence rates of obesity will likely continue with growing incomes since the turning point of the income BMI gradient has not yet been reached. Nevertheless, transmission channels of rising incomes that lead to rising BMI rates are not fully revealed.
Chapter 2 and Chapter 3 provide evidence on long-term effects which can be explained by daily behavior. At the same time, the factors that influence people’s lifestyle decisions (healthy versus unhealthy nutrition and physical activity versus inactivity) must be taken into consideration from different perspectives, such as cultural, political, economic, and psychological perspectives. As obesity is a byproduct of other lifestyle choices (at least in most westernized countries) such as sedentary lifestyles and changed cooking behavior, effective strategies to reduce excess body weight should rely on a mixture of strategies.
Instead of focusing (blames and policies) on the individual (and blaming him), it would be preferable that policies and programs need to readjust their approach. Health programs to prevent overweight and obesity already in childhood could be one way. Since it is mostly the mothers that prepare meals for the children (and the whole family) and therefore make nutritional choices (and since obesity is more prevalent among women), women and children should be in the focus of prevention programs. So, schools should adopt measures to offer
“healthy” food, education programs are needed and maybe also worksites could be changed towards an environment that fosters nutritious food and opportunities for being physically active. From the political perspective, we can think of food labelling, such as multiple traffic light systems to inform people about the fat and sugar content of food to influence their shopping behavior. Since we find that long-term factors seem to matter a lot, we conclude
that a cultural change from the bottom up holds promise, so people need to be involved.
Relevant social theories are needed to design intervention programs and to include the issue of overweight related health issues that highly increase the risk of non-communicable diseases.
Chapter 4 evaluates the potential contribution of regional climate agreements on mitigation of climate change. By classifying 16 agreements by their subject and evaluating several criteria such as compliance and reduction mechanisms, as well as budget, we assess the potential effect of the agreements that they might have on the reduction of GHG emissions. The incentives to join an agreement often stem from the fact that neighboring countries are equally negatively affected by consequences of climate change. Furthermore, the implementation of advanced technologies that might result from technology and R&D agreements promises a competitive advantage that countries do not want to miss. Trade-related agreements originate from existing collaboration with partners (in other fields) and oftentimes do not mention clear goals. Finance agreements are of special interest for developing countries that do not have the financial capacities to fund mitigation projects. None of the evaluated agreements names clear and quantifiable goals or compliance mechanisms. A powerful measure seems to be an implemented monitoring mechanism (as implemented by the APEC FSSEA) which can serve as a “name-and-shame” system. Lately – in December 2015 – the Paris Agreement has been adopted by 195 governments, which is (or would be – when ratified by its member states) the first-ever universal, legally binding global climate deal. To avoid dangerous climate change by limiting global warming to below 2°C it sets out a global action plan to put the world on track. The Paris Agreement hopefully results in the implementation of various programs and measures to prevent the climate from further warming. In consequence, after some time it will not be easy to identify impacts of different agreements. However, if the goal of limiting global warming to 2°C comes within the range of vision it might be less important to identify the individual most successful strategy.
Inequality and Income Growth in Russia
Abstract
This study analyzes the extent to which nutritional status in terms of weight change has been affected by the income distribution as the economy has grown. Is BMI growth different at different tails of the income distribution? Health and nutritional outcomes are not normally expected to be uniform across the income distribution and over time. Using recent individual level data from the Russia Longitudinal Monitoring Survey (RLMS) from 1994 to 2012, we scrutinize the influence of transitional processes, particularly economic transitions on nutritional and health outcomes. We test the hypothesis that the income gradient of individual body weight growth (i.e. the relationship between income and BMI growth) follows an inverted U-shape and thus changes its sign from positive to negative in the process of economic development. For the case of Russia, we could not find clear evidence that the income-BMI-growth gradient has already shifted. Turning points have not yet been reached.
Expenditure increases have significant positive effects on BMI levels and on BMI growth rates. Better educated women have lower BMI levels than women with less than secondary education whereas men who completed tertiary education have higher BMI levels than men with less than secondary education.
JEL classifications: H51, I15, O15, P36
Keywords: Overweight, obesity, health, transition economy, Russia