Oyebode Oyinlola, Pape Utz J, Laverty Anthony A, Lee John T, Bhan Nandita, Millett Christopher
Department of Primary Care and Public Health, Imperial College, Reynolds Building, St Dunstand's Road, London, United Kingdom.
Public Health Foundation of India, New Delhi, India.
PLoS One. 2015 Apr 7;10(4):e0122747. doi: 10.1371/journal.pone.0122747. eCollection 2015.
Understanding how urbanisation and rural-urban migration influence risk-factors for non-communicable disease (NCD) is crucial for developing effective preventative strategies globally. This study compares NCD risk-factor prevalence in urban, rural and migrant populations in China, Ghana, India, Mexico, Russia and South Africa.
Study participants were 39,436 adults within the WHO Study on global AGEing and adult health (SAGE), surveyed 2007-2010. Risk ratios (RR) for each risk-factor were calculated using logistic regression in country-specific and all country pooled analyses, adjusted for age, sex and survey design. Fully adjusted models included income quintile, marital status and education.
Regular alcohol consumption was lower in migrant and urban groups than in rural groups (pooled RR and 95%CI: 0.47 (0.31-0.68); 0.58, (0.46-0.72), respectively). Occupational physical activity was lower (0.86 (0.72-0.98); 0.76 (0.65-0.85)) while active travel and recreational physical activity were higher (pooled RRs for urban groups; 1.05 (1.00-1.09), 2.36 (1.95-2.83), respectively; for migrant groups: 1.07 (1.0 -1.12), 1.71 (1.11-2.53), respectively). Overweight, raised waist circumference and diagnosed diabetes were higher in urban groups (1.19 (1.04-1.35), 1.24 (1.07-1.42), 1.69 (1.15-2.47), respectively). Exceptions to these trends exist: obesity indicators were higher in rural Russia; active travel was lower in urban groups in Ghana and India; and in South Africa, urban groups had the highest alcohol consumption.
Migrants and urban dwellers had similar NCD risk-factor profiles. These were not consistently worse than those seen in rural dwellers. The variable impact of urbanisation on NCD risk must be considered in the design and evaluation of strategies to reduce the growing burden of NCDs globally.
了解城市化和城乡迁移如何影响非传染性疾病（NCD）的风险因素对于在全球范围内制定有效的预防策略至关重要。本研究比较了中国、加纳、印度、墨西哥、俄罗斯和南非城市、农村及移民人群中NCD风险因素的患病率。
研究参与者为39436名成年人，来自世界卫生组织全球老龄化与成人健康研究（SAGE），于2007年至2010年进行调查。在特定国家和所有国家汇总分析中，使用逻辑回归计算每个风险因素的风险比（RR），并对年龄、性别和调查设计进行调整。完全调整模型包括收入五分位数、婚姻状况和教育程度。
移民和城市人群的经常饮酒率低于农村人群（汇总RR及95%置信区间分别为：0.47（0.31 - 0.68）；0.58，（0.46 - 0.72））。职业体力活动较低（0.86（0.72 - 0.9`8）；0.76（0.65 - 0.85）），而主动出行和休闲体力活动较高（城市人群汇总RR分别为：1.05（1.00 - 1.09），2.36（1.95 - 2.83）；移民人群分别为：1.07（1.0 - 1.12），1.71（1.11 - 2.53））。城市人群超重、腰围增加和确诊糖尿病的患病率较高（分别为1.19（1.04 - 1.35），1.24（1.07 - 1.42），1.69（1.15 - 2.47））。这些趋势存在例外情况：俄罗斯农村地区的肥胖指标较高；加纳和印度城市人群的主动出行较低；在南非，城市人群的酒精消费量最高。
移民和城市居民具有相似的NCD风险因素特征。这些特征并不总是比农村居民的情况更糟。在设计和评估减轻全球日益增加的NCD负担的策略时，必须考虑城市化对NCD风险的可变影响。
