Socioeconomic and demographic correlates of nutritional status in urban dwelling elderly of Havana, Cuba

Abstract

Background: Malnutrition among the elderly constitutes a significant public health concern in Cuba and the wider Caribbean. Its frequent onset in the region is primarily driven by age-related medical conditions, unhealthy dietary patterns, and low levels of physical activity. There is also a growing body of evidence suggesting that socioeconomic and demographic factors contribute to the risk of malnutrition and and may serve as modifiable determinants of weight regulation and nutritional health.

Aims: The primary objective of this study was to investigate the prevalence of underweight, overweight, and obesity in older adults residing in urban Havana, Cuba, in relation to various socioeconomic and demographic factors.

Patients and Methods: A cross-sectional descriptive study was conducted with 320 older Cubans, aged 60–95 years, from the urban neighborhood of Miramar, Havana. Body weight and height were measured using standard procedures. The World Health Organization (WHO) body mass index (BMI) cut-offs were applied to classify participants as underweight, overweight, or obese. Socioeconomic and demographic data were also collected. The influence of these variables on nutritional status was analyzed employing descriptive statistics and logistic regression models. Furthermore, cluster analysis was performed to identify the specific socioeconomic groups at higher risk of either underweight or overweight/obesity.  

Results: The study found a prevalence of 3.0% for underweight, 45.7% for overweight, and 19.7% for obesity. Participants living in small elderly households composed of elderly individuals, those who were employed, or those with low educational level were more likely to be underweight. Conversely, individuals in large, cross-generational households, those who were retired, or those with a high educational level displayed a greater likelihood of being overweight and obese. Cluster analysis further indicated that the effects of these socioeconomic correlates are additive. The highest risk for being underweight was observed in participants with low education, living in small elderly households and who were still employed. In contrast, those with high education, residing in large, cross-generational households, and who were retired fac ed a greater risk of overweight/obesity.

Conclusions: Underweight, overweight and obesity in older adults in Havana are significantly associated with distinct socioeconomic and demographic factors. The strongest associations were found with employment status, educational level, and household size, both individually and in combination.  Underweight status showed a positive correlation with low educational level, employment, and residence in small elderly households. In contrast, overweight/obesity was positively correlated with high educational level, retirement status, and living in large cross-generational households. Incorporating these findings into local public health policy and clinical practice could significantly improve the management of malnutrition in this population.

Keywords: Underweight; Overweight; Elderly; Socioeconomic risk, Cuba, Caribbean.