Adolescent obesity is associated with high cardiovascular and metabolic risk.
Western diet and reduced physical activity are strong environmental
determinants. The “Health Production” model posits that individuals born with a
certain amount of health stock, which depreciates over life, but can be
augmented by individual behaviors, including exercise and dieting. Objective:
To study the association between health production and obesity in a random
sample of 1692 Chilean adolescents (14.8 ± 0.7 years old), and to study the
effect of gender and socioeconomic characteristics on health production.
Method: We used an indicator that considered the quality of food intake and
physical activity, establishing three categories: good (GHP), intermediate
(IHP) and poor health producers (PHP). Multivariate analysis was used to
study the odds of obesity and good health production. Results: There was 31%
of GHP, 32% of IHP and 38% of PHP. Obesity (Adj. OR: 1.59; 95%CI: 1.04 - 2.42)
and abdominal obesity (Adj. OR: 2.24; 95%CI: 1.35 - 3.40) were significantly
higher in the PHP group, compared to the GHP and IHP group. Health production
was significantly associated with socioeconomic factors and gender. Female
sex and coming from a less wealthy household significantly reduced the odds of
good health production. Conclusions: Poor health production in adolescence, as
defined by food intake and physical activity, depreciates individuals’ “health stock”, increasing the risk of
obesity. In our sample, health production was strongly associated with socio-economic factors and gender.
Cite this paper
Correa-Burrows, P. , Burrows, R. , Uauy, R. and Albala, C. (2012) Health production and risk of obesity among Chilean adolescents: Understanding health related behaviors in youth. Health, 4, 1413-1419. doi: 10.4236/health.2012.412A204.
 Vio, F., Albala, C. and Kain, J. (2008) Nutrition transition in Chile revisited. Mid-term evaluation of obesity goals for period 2000-2010. Public Health Nutrition, 11, 405-412. doi:10.1017/S136898000700050X
 Cecchini, M., Sassi, F., Lauer, J., Lee, Y., Guajardo-Barron, V. and Chisholm, D. (2010) Tackling of unhealthy diets, physical inactivity, and obesity: Health effects and cost-effectiveness, The Lancet, 376, 1775-1784.
 OECD Health Data (2011) Organization for economic Cooperation and Development, Paris.
 National Health Survey (2010) Ministry of health, Santiago de Chile.
 Levy-Marchal, C., Arslanian, S., Cutfield, W., Sinaiko, A., Druet, C., Marcovecchio, M.L., et al. (2010) Insulin Resistance in children: Consensus, perspective and future directions. Journal of Clinical Endocrinology and Metabolism, 95, 189-198. doi:10.1210/jc.2010-1047
 Burrows, R., Leiva, L., Weisstaub, G., Lera, L., Albala, C., Blanco, E. and Gahagan, S. (2011) High HOMA-IR, adjusted for puberty, relates to the metabolic syndrome in overweight and obese chilean youths. Pediatrics Diabetes, 12, 212-218. doi:10.1111/j.1399-5448.2010.00685.x
 Reilly, J. and Kelly, J. (2011) Long-term impact of over-weight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: A systematic review. International Journal of Obesity, 35, 891-898.
 Sun, S.S., Liang, R., Huang, J.J.K., Daniels, S.R., Arsanian, S., Liu, K., Grone, G. and Siervogel, R. (2008) Childhood obesity predicts adult metabolic syndrome: The Fels Longitudinal Study. Journal of Pediatrics 152, 191-200. doi:10.1016/j.jpeds.2007.07.055
 Muzzo, S., Cordero, J., Ramírez, I. and Burrows, R. (2004) Trends in nutritional status and stature among school age children in Chile. Nutrition, 20, 867-973.
 Kain, J., Uauy, R., Lera, L., Taibo, M. and Albala, C. (2005) Trends in height and BMI of 6-year-old children during the nutrition transition in Chile. Obesity Research, 13, 2178-2186. doi:10.1038/oby.2005.270
 Guzmán, J., Lyra, R., Aguilar-Salinas, C., et al. (2010) Treatment of type 2 diabetes in Latin America: A consensus statement by the medical associations of 17 Latin American countries. Revista Panamericana de Salud Pública, 28, 463-471.
 Sassi, F. (Ed.) (2010) Obesity and the economics of pre- vention. Organization for Economic Cooperation and Development, Paris.
 Grossman, M. (1972) The demand for health: A theoretical and empirical investigation. National Bureau of Economic Research, New York.
 Grossman, M. (1972) On the concept of health capital and the demand for health. Journal of Political Economy, 80, 223-255. doi:10.1086/259880
 Winkleby, M., Jatulis, D., Frank, E. and Fortman, S. (1992) Socioeconomic status and health: How education, income and occupation contribute to risk factors for cardiovascular disease. American Journal of Public Health, 82, 816. doi:10.2105/AJPH.82.6.816
 Wagstaff, A. (1993) The demand for health: An empirical reformulation of the Grossman model. Journal of Health Economics, 2, 189-198. doi:10.1002/hec.4730020211
 Grossman, M. (1999) The human capital model of the demand for health. Working Paper 7078, National Bureau of Economic Research, New York.
 Wilson, J. (2003) The crucial link between literacy and health. Annals of Internal Medicine, 139, 875-878.
 Levine, J. (2011) Poverty and Obesity in the US. Diabetes, 60, 2667-2668.
 De Vanzo, J. and Gertler, P. (1990) Household production of health. A microeconomic perspective. RAND Corporation, Santa Monica.
 Anderson, P., Butcher, K. and Levine, P. (2003). Maternal employment and overweight children. Journal of Health Economics, 22, 477-504.
 Burrows, R., Montoya, A., Gattas, V., Díaz, E., Sciaraffia, V. and Lera, L. (2008). Intake and physical activity habits among elementary and high school children by type of school attended. Revista Médica de Chile, 136, 53-63.
 Godard, C., Rodríguez, M.P., Díaz, N., Lera, L., Salazar, G. and Burrows, R. (2008). Evaluation of a test to assess physical activity habits in school children. Revista Médica de Chile, 136, 1155-1162.
 Chillón, P., Ortega, F., Ruiz, J., Pérez, I., Martín-Matilla, M., Valtue?a, J., et al. (2009). Socio-economic factors and active commuting to school in urban Spanish adolescents: The AVENA Study. European Journal of Public Health 19, 470-476. doi:10.1093/eurpub/ckp048
 Martínez-Gómez, D., Veiga, O., Gómez-Martínez, S., Zapatera, B., Calle, M. and Marcos, A. (2011). Behavioural correlates of active commuting to school in Spanish adolescents: The AFINOS Study. Public Health Nutrition, 14, 1779-1786.
 Xu, K., Evans, D.B., Kawabata, K., Zeramdini, R., Klavus, J. and Murray, C.J. (2003) Household catastrophic health expenditure: A multicountry analysis. The Lancet, 362, 111-117. doi:10.1016/S0140-6736(03)13861-5
 World Health Organization (2010) The World Health Report. Health systems financing: The path to universal coverage. WHO, Geneva.