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Shifting the obesity epidemic in Iberia-Latin American cities: applying interdisciplinary, intersectional and intersectoral approaches to understand and change key obesogenic causes

Periodic Reporting for period 1 - OE-ILAC (Shifting the obesity epidemic in Iberia-Latin American cities: applying interdisciplinary, intersectional and intersectoral approaches to understand and change key obesogenic causes)

Período documentado: 2021-03-22 hasta 2023-03-21

Excess weight (overweight/obesity) has reached pandemic proportions in recent decades and is one of the most important public health concerns worldwide. Two other growing phenomena coexist and interact with the complex pandemic of overweight/obesity: social inequalities and urbanization. Overall, overweight/obesity is less common in more equal societies, and overweight/obesity prevalence as well as social inequalities are usually higher in more urban areas.
Despite the implementation of numerous policies and interventions in the last decades, no country thus far successfully managed to reverse the overweight/obesity trends in the adult population. The focus has been traditionally placed on individual behaviours and responsibility, but it is necessary to move the field forward with interventions on the ‘root causes’: the social, economic, commercial, and political determinants.
In spite of the considerable scientific evidence, what are the main drivers of the intertwined social and gender inequalities in overweight/obesity in urban contexts of the Ibero-American region, and to what extent public policies and interventions acknowledge that is still unclear. The aims of the OE-ILAC project are to identify the determinants of social and gender inequalities in overweight/obesity in cities of Latin America and the Iberian Peninsula, to analyse public policies intended to prevent this condition, and to develop recommendations for policies and interventions by applying interdisciplinary, intersectional, and intersectoral approaches.
Overall, OE-ILAC findings highlight the need of: i) improving women’s empowerment alongside focusing interventions in the most socially disadvantaged groups to address the gendered overweight/obesity pandemic in Latin America; ii) developing more context-specific policy interventions and considering the interplay between the place of residence and the social position of the individuals to tackle the persistent social and gender inequalities in overweight/obesity in Spain; iii) acknowledging the intersectional configuration (i.e. the intertwined social and gender inequalities) of excess weight to address this pandemic (particularly in Mexico but applicable to other countries of the region); and iv) promoting equity-based and context-sensitive policies and interventions to prevent overweight/obesity in Ibero-America.
The project was organized and executed across five interconnected Work Packages (WP): WP1 management of the action; WP2 training and transfer of knowledge; WP3 dissemination, exploitation, communication and public engagement; WP4 cross-sectional study; and WP5 public policies analysis. In the first stage of the project, the variation in overweight/obesity in a wide range of cities in different countries in Latin America and the Iberian Peninsula was estimated, observing that a modest proportion of such variation was attributed to influences from city and geographic units within city levels. Then, multilevel determinants of the social and gender inequalities of overweight/obesity in cities were identified, such as the social position, the women empowerment and the income inequality. The findings of this work suggest considerable heterogeneity in the social and gender inequalities in overweight/obesity, and that an interplay between the social position of individuals and the social conditions of their place of residence shapes the social pattern of overweight/obesity in the region (WP4). In the second stage of the project, a qualitative documental analysis of public policies and intervention strategies to prevent overweight/obesity in Mexico was developed -the country in the Ibero-American region most affected by overweight/obesity-, applying an intersectional perspective. The main findings indicated that most public policies considered relatively few axes of social inequality and lacked an intersectional perspective. Overall, public policies and interventions considered social inequalities mainly in the definition of the problem, and to a much lesser extent, in the proposed solutions and in the consultation and negotiation processes. Finally, the results of the project allowed for developing recommendations for policies and interventions to address social and gender inequalities in overweight/obesity in cities (WP5).
The project activities and results were also disseminated, exploited, and communicated to a wider audience, through workshops, seminars, debates, newspaper articles, social media releases, outreach activities, among others (WP3). Throughout the fellowship, the researcher attended several training courses, which enabled her to enhance existing skills and acquire new ones. Moreover, two secondments (one of them non-academic) and a short visit were developed during the action (WP2). Overall, the objectives of the action were satisfactorily achieved.
The OE-ILAC drew on the innovative combination of integrative transversal approaches: interdisciplinary (involving a mix of disciplines such as epidemiology, demography, sociology, geography, medicine, nutrition, statistics, anthropology, urban planning, and political science), intersectional (analysing the complex interplay among different axes of inequality such as social position, gender, and place of residence), intersectoral (engaging academics, civil society, stakeholders, health practitioners, and non-governmental organisation agents) and transnational (involving several countries as well as international mobility and strong networking and collaborations). Overall, OE-ILAC extended the state of the art of the urban social determinants of social and gender inequalities in overweight/obesity in the Ibero-American region, created an innovative and comprehensive approach for analysing the complex issue of overweight/obesity, brought a decision support tool for designing policies to prevent it with equity criteria, and provided insights for reframing overweight/obesity as a systemic problem.
Through the activities of the OE-ILAC project, the researcher has gained invaluable skills and experience in interdisciplinary, international, and intersectoral collaboration, project management, knowledge transfer, and public science communication. This has broadened her capabilities spectrum, enhancing her expertise, expanding her international networks, and establishing a strong foundation for future success in her career. Additionally, the project incorporated various initiatives to disseminate findings, foster dialogues, and raise awareness among stakeholders and the general public. The findings and insights generated provided evidence-based support for policy interventions aiming to reduce social and gender disparities in overweight/obesity.
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