OBEZİTE VE YOKSULLUK: TÜRKİYE ÖRNEĞİ

Gelişmiş ve gelişmekte olan ülkelerde obezite yıkıcı etkiye sahip bir sağlık problemidir. Sosyoekonomik statü ile obezite arasında ilişkide net bir sonuca varılamamıştır. Türkiye’de yoksulluk oranındaki artışa bağlı olarak gelir eşitsizliği artış göstermektedir. Türkiye’de artan obezite ve gelir eşitsizliği sorununu anlayabilmek için gelir eşitsizliğinin obezite yaygınlığı üzerindeki rolünü araştırmak gerekir. Bu çalışmanın amacı yoksulluk durumu ile obezite/aşırı kilolu arasındaki ilişkiyi incelemektir. Çalışmada iki farklı yöntem kullanılmıştır. İlkinde obezite ile yoksulluk arasındaki ilişkide yoksulluğun içselliğini göz ardı edilerek oluşturulan probit model ele alınmıştır. İkincisinde ise obezite ile yoksulluk arasında eş zamanlı ilişkisini ve yoksulluğun içselliği göz önünde bulunduran yinelenen iki değişkenli probit model tercih edilmiştir. Analizde Türkiye İstatistik Kurumu tarafından oluşturulan 2019 yılına ait Türkiye Sağlık Araştırması veri setinden yararlanılmıştır. Her iki model için yoksulluk ile obez/aşırı kilolu arasında negatif ilişki olduğu sonucuna varılmıştır. İki değişken arasında içsellik sorunu olduğunu ve yoksulluğun obezite/aşırı kilo olma olasılığını %21.6 azalttığı sonucuna varılmıştır. Ayrıca, yaş, cinsiyet, eğitim, medeni durum, çalışma durumu, sigara ve alkol kullanım gibi önemli faktörler obez/aşırı kilo ve yoksulluk üzerinde istatistiksel olarak anlamlıdır. Önemli bulgulardan biriside eğitim düzeyindeki artış yoksulluk ve obez/aşırı kilolu olma olasılığını azaltıcı etkisi bulunmuştur.

Anahtar Kelimeler:

Obezite, Yoksulluk, Sosyoekonomik Statü, Yinelenen İkili Probit Model

OBESİTY AND POVERTY: EVİDENCE FROM TURKEY

Obesity is a devastating health problem in developed and developing countries. There is no clear relationship between socioeconomic status and obesity. Income inequality is increasing due to the increase in the poverty rate in Turkey. In order to understand the increasing obesity and income inequality problem in Turkey, it is necessary to investigate the role of income inequality on obesity prevalence. The aim of this study is to examine the relationship between poverty status and obesity/overweight. Two different methods were used in the study. In the first, a probit model was created by ignoring the endogeneity of poverty in the relationship between obesity and poverty. In the second, Recursive bivariate probit model was preferred, which considers the simultaneous relationship between obesity and poverty and the endogeneity of poverty. In the analysis, we use Health Survey of Turkish Statistical Institute for the year 2019. It was concluded that there is a negative relationship between poverty and obese/overweight for both models. It was concluded that there is an endogeneity problem between the two variables and that poverty reduces the probability of obesity/overweight by 21.6%. In addition, important factors such as age, gender, education status, marital status, employment status, smoking and alcohol use are statistically significant on obesity/ overweight and poverty. One of the important findings is that the increase in the level of education has a decreasing effect on the possibility of poverty and being obese/overweigh.

Keywords:

: Obesity, Poverty, Socioeconomic Status, Recursive Bivariate Probit Model,

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Abdulai, A. (2010). Socio‐economic characteristics and obesity in underdeveloped economies: Does income really matter?, Applied Economics, 42(2), 157–169.
Amarasinghe, A., D’Souza G., Brown C., Oh H. ve Borisova T. (2009). The influence of socioeconomic and environmental determinants on health and obesity: A West Virginia case study. International Journal of Environmental Research and Public Health, Vol 6, 2271-2287.
Baum, C. (2009). The effects of cigarette costs on BMI and obesity. Health Economics, 18(1): 3-19.
Bell, C. G., Walley, A. J. ve Froguel, P. (2005). The genetics of human obesity. Nature Reviews Genetics, 6(3), 221–234.
Benlagha, N. ve Karaa, I. (2017). Evidence of adverse selection in automobile insurance market: A seemingly unrelated probit modelling. Cogent Economics & Finance, 5(1).
Beyaz Sipahi, B. (2020). Hanehalkı geliri ve beden kitle indeksi arasındaki ilişki: araç değişken yaklaşımı. ISPEC Journal of Social Sciences & Humanities,4(2), 77-97.
Chou, S., Grossman, M. ve Saffer, H. (2004). An economic analysis of adult obesity: results from the behavioral risk factor surveillance system. Journal of Health Economics, 23(3), (2004), 565-587.
Dinsa, G. D., Goryakin, Y., Fumagalli, E. Ve Suhrcke, M. (2012). Obesity and socioeconomic status in developing countries: Asystematic review. Obesity Reviews, 13(11), 1067–1079.
Drewnowski A. ve Specter S., (2004). Poverty and obesity: The role of energy density and energy costs. American Journal of Clinic Nutrition, 79(6), 6-16.
Dogbe, W. (2020). Can poverty status explain obesity in developing countries? Evidence from Ghana, Agribusiness, John Wiley & Sons, Ltd., vol. 37(2), 409-421.
Erem C., Arslan C., Hacıhasanoğlu A., Değer O., Topbaş M., Ukinc K., Ersöz H.Ö., Telatar. Filippini, M., Greene, W. H., Kumar, N. Ve Martinez‐Cruz, A. L. (2018). A note on the different interpretation of the correlation parameters in the bivariate probit and the recursive bivariate probit. Economics Letters, 167, 104–7.
Garcia‐Álvarez, A., Serra‐Majem, L., Ribas‐Barba, L., Castell, C., Foz, M., Uauy, R. ve Salleras, L. (2007). Obesity and overweight trends in Catalonia, Spain (1992–2003): Gender and socio‐economic determinants. Public Health Nutrition, 10(11A), 1368–1378.
Greene, W. H. (1998). Limited dependent variables—Truncation, censoring and sample selection, econometric analysis. New Jersey, NJ: Prentice‐Hall.
Grossman, M. J., Sindelar, L., Mullahy, J. ve Anderson, R. (1993). Alcohol and cigarette. Journal of Economic Perspective, 7(4), 211-222.
Grossman, M. (2001). The economics of substance use and abuse: The role of price, in economic analysis of substance use and abuse: The experience of developed countries and lessons for developing countries, edited by Michael Grossman and Chee-Ruey Hsieh, Cheltenham, U.K, 1-30.
Kanter, R. ve Caballero, B. (2012). Global gender disparities in obesity: A review. Advances in Nutrition, 3(4), 491–498.
Karaoğlan D. ve Tansel A. (2019). Determinants of Body Mass Index in Turkey: A Quantile Regression Analysis from a Middle Income Country. Boğaziçi Journal Review of Social, Economic and Administrative Studies, Vol. 32, no. 2, pp. 01-17.
Karaoğlan, D. (2019). Sigarayı bırakma ve obezite arasındaki ilişki: Türkiye örneği. Journal of Research in Economics, 3 (1) , 46-57.
Kenkel D. (1991). Health behavior, health knowledge and schooling. Journal of Political Economy, vol. 99, 287-305.
Lamerz, A., Kuepper‐Nybelen, J., Wehle, C., Bruning, N., Trost‐Brinkhues, G., Brenner, H. ve Herpertz‐Dahlmann, B. (2005). Social class, parental education, and obesity prevalence in a study of six‐year‐old children in Germany. International Journal of Obesity, 29(4), 373–380.
Lewbel, A., Dong, Y. ve Yang, T. T. (2012). Comparing features of convenient estimators for binary choice models with endogenous regressors. Canadian Journal of Economics, 45(3),809-829.
Loureiro, M.L. ve Nayga, R.M. (2005). Obesity rate in OECD countries: An international perspective. Presentation at the EAAE XI Congress-Copenhagen, (2005), 1-19.
Maddala, G. S. (1986). Limited‐dependent and qualitative variables in econometrics. 3, Cambridge, UK: Cambridge University Press.
McLaren, L. (2007). Socioeconomic status and obesity. Epidemiologic Reviews, 29(1), 29–48.
Marra, G., Papageorgiou, G. ve Radice, R. (2013). Estimation of a semiparametric recursive bivariate probit model with nonparametric mixing. Australian and New Zealand Journal of Statistics, 55(3), 321–342.
Mokdad, A. H., Serdula, M. K., Dietz, W. H., Bowman, B. A., Marks, J. S. ve Koplan, J. P. (1999). The spread of the obesity epidemic in the United States, 1991-1998. Jama, 282(16), 1519-1522.
Monteiro, C. A., Moura, E. C., Conde, W. L. ve Popkin, B. M. (2004). Socioeconomic status and obesity in adult populations of developing countries: A review. Bulletin of the World Health Organization, 82, 940–946.
O’Donnell O., van Doorslaer E., Wagstaff A. ve Lindelow M., (2008). Analyzing health equality using household survey data. World Bank Institute, chapter 8.
Philipson T. ve Posner R. (2008). Is the obesity epidemic a public health problem? A decade of research on the economics of obesity. Working Paper 14010, National Bureau of Economic Research, Cambridge, 1-15.
Popkin B.M. (2001). The nutrition transition and obesity in the developing World. Journal of Nutrition, 131, (2001), 871-873.
Renna, F. ve Thakur, N. (2010). Direct and indirect effects of obesity on US labor market outcomes of older working age adults. Social Science & Medicine, 71(2), 405-413.
Römling C. ve Qaim M. (2011). Direct and indirect determinants of obesity: The case of Indonesia. Proceedings of the German Development Economics Conference, Berlin, No.70, (2011), 129.
Sobal, J. ve Hanson, K. L. (2011). Marital status, marital history, body weight, and obesity. Marriage & Family Review, 47(7), 474–504.
Sobal, J. ve Stunkard, A. J. (1989). Socioeconomic status and obesity: A review of the literature. Psychological Bulletin,105(2), 260–275.
Tansel A. ve Karaoğlan D., (2014). Health behaviors and education in Turkey. Koç University-TÜSİAD Economic Research Forum Working Paper Series, working paper 1414,1-40.
Tansel A. ve Karaoğlan D., (2016). The causal effect of education on health behaviors: evidence from Turkey. Economic Research Forum Working Paper No 1030, 1-26.
Thiele S. ve Roosen, J. (2018). Obesity, fat taxes and their effects on consumers. regulating and managing food Safety in the EU (pp. 169–193). Cham, Switzerland: Springer.
Trogdon, J. G., Finkelstein, E. A., Hylands, T., Dellea, P. S. ve Kamal-Bahl, S. J. (2008). Indirect costs of obesity: A review of the current literature. Obesity Reviews, 9(5), 489-500.
Uvalić‐Trumbić, S. ve Daniel, J. (2016). Sustainable development begins with education. Journal of Learning for Development,3(3), 3–8.
Türkiye İstatistik Kurumu (TÜİK), 2019 Türkiye Sağlık Araştırması Veri Seti.
Türkiye İstatistik Kurumu (TÜİK), Haber Bülteni, Gelir ve Yaşam Koşulları Araştırması, 2020, Sayı 37404; Erişim tarihi:20.01.2022.
Türkiye İstatistik Kurumu (TÜİK), Haber Bülteni, Hanehalkı Tüketim Harcaması, 2019, sayı 33593, https://data.tuik.gov.tr/Bulten/Index?p=Household-Consumption-Expenditures-2019-33593.
Yumuk, V. D. (2005). Prevalence of obesity in Turkey. Obesity Reviews, 6(1): 9-10.
Żukiewicz‐Sobczak, W., Wróblewska, P., Zwolinski, J., Chmielewska‐Badora, J., Adamczuk, P., Krasowska, E. ve Silny, W.(2014). Obesity and poverty paradox in developed countries. Annals of Agricultural and Environmental Medicine, 21(3),590–594.
World Health Organization (WHO). (2018). Obesity and overweight. https://www.who.int/news‐room/fact‐sheets/detail/obesity‐and‐overweight, Erişim tarihi:20.01.2022.
World Health Organization-European, Health Topics-Obesity, https://www.euro.who.int/en/health-topics/noncommunicable-diseases/obesity, Erişim Tarihi: 20.01.2022.