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    Early-life exposures and childhood obesity and overweight in Türkiye
    (Turkish Society of Public Health Specialists, 2023) Aktar, Rengin
    Objective: Childhood overweight and obesity have seen a dramatic increase in Turkey and other middle-income countries over the last decades. By using anthropometric data, this study examines the influence of early-life exposures during pregnancy and infancy on young children’s risk of developing overweight and obesity. Methods: Study uses five cross-sections of Demographic and Health Surveys (DHS) conducted in Turkey between 1993 and 2013. A total of 9719 children between the ages of 2 and 5 are used to estimate the prevalence rates of obesity and overweight. In addition, a logistic regression model is applied to 5013 children in order to assess the main determinants of obesity and overweight. Results: There is a notable increase in the prevalence rates of obesity and overweight in children between 1993 and 2013, the peak prevalence has been reached in 2008. Results of the logistic regression reveal that early-life factors; maternal obesity and high birth weight are significantly associated with the risk of obesity and overweight in young children. Among socio-economic variables, living both in the richest and poorer households are positively and significantly associated with the risk of obesity and overweight. Conclusion: Public health efforts to prevent childhood obesity and overweight would be incomplete without considerations of maternal health and nutrition during pregnancy.
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    Ready-Willing-Able: Early childhood mortality decline in Turkey
    (Routledge Journals, Taylor & Francis Ltd, 2022) Aktar, Rengin; Palloni, Alberto
    We test a conjecture to explain Turkey's decades-long 'underachievement' in early child mortality improvements. We argue that it is largely a consequence of cultural barriers to embracing available modern medical technology and healthcare practices. The empirical test rests on a reformulation of Coale's Ready-Willing-Able (RWA) framework for explaining fertility changes, which makes it suitable to understand mortality changes. We use structural equation modelling and Demographic and Health Surveys spanning 1993-2013 to estimate basic parameters of the reformulated framework. These parameters are then used to classify mothers into four groups with different configurations of RWA dimensions and different probabilities of adopting modern medical practices. We find that observed behaviours in these groups were consistent with RWA expectations. In addition, we find that an important contributor to Turkey's lagging mortality decline was a population distribution biased towards groups more reticent to adopting modern healthcare.