Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban char...

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Published inPLoS medicine Vol. 11; no. 7; p. e1001683
Main Authors Riha, Johanna, Karabarinde, Alex, Ssenyomo, Gerald, Allender, Steven, Asiki, Gershim, Kamali, Anatoli, Young, Elizabeth H, Sandhu, Manjinder S, Seeley, Janet
Format Journal Article
LanguageEnglish
Published United States Public Library of Science 01.07.2014
Public Library of Science (PLoS)
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Summary:Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases. Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77). This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA. Please see later in the article for the Editors' Summary.
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Conceived and designed the experiments: JR SA MSS. Performed the experiments: JR AK GS GA. Analyzed the data: JR MSS. Wrote the first draft of the manuscript: JR MSS. Contributed to the writing of the manuscript: JR SA AK EHY MSS JS. ICMJE criteria for authorship read and met: JR AK GS SA GA AK EHY MSS JS. Agree with manuscript results and conclusions: JR AK GS SA GA AK EHY MSS JS.
These authors are joint senior authors on this work.
The authors have declared that no competing interests exist.
ISSN:1549-1676
1549-1277
1549-1676
DOI:10.1371/journal.pmed.1001683