Yaya Sanni, Uthman Olalekan A, Ekholuenetale Michael, Bishwajit Ghose
School of International Development and Global Studies, University of Ottawa, Ottawa, ON, Canada.
Division of Health Sciences, Warwick Centre for Applied Health Research and Delivery, Warwick Medical School, University of Warwick, Coventry, United Kingdom.
Front Public Health. 2018 Oct 24;6:307. doi: 10.3389/fpubh.2018.00307. eCollection 2018.
Understanding the socioeconomic discordance associated with the risk factors of non-communicable diseases (NCDs) can help direct effective interventions to end its persistent occurrence. We examined the prevalence of high blood pressure, overweight/obesity, alcohol consumption and tobacco use among women and compared across wealth quintiles in sub-Saharan Africa countries. This study included 454,080 women of reproductive age (15-49 years) from the current Demographic and Health Survey (DHS) conducted between 2008/09-2017 across 33 sub-Saharan Africa countries. The outcome variables were high blood pressure, overweight/obesity, alcohol consumption and tobacco use. The prevalence of the risk factors of NCDs and sample characteristics across different levels of wealth quintiles were examined. Furthermore, socioeconomic inequalities were measured using concentration index (CI) and Lorenz curve considering urban-rural differentials. The prevalence of high blood pressure and overweight/obesity were 1.2-17.3% and 6.7-44.5% respectively with significant wealth quintile differences. More so, alcohol consumption prevalence was 4.1-47.3% and tobacco use was 0.3-9.9%. The overall prevalence of high blood pressure was 5.5%, overweight/obesity accounted for about 23.1%, alcohol consumption and tobacco users were 23.9 and 2.4%, respectively. The socioeconomic inequalities in high blood pressure (CI = 0.1352, < 0.001); overweight/obesity (CI = 0.2285, < 0.001), and alcohol consumption (CI = 0.0278, < 0.001) were significantly more in the higher socioeconomic group, compared to the lower socioeconomic group. In contrast, the prevalence of tobacco use ( = -0.2551, < 0.001) was significantly more in the lower socioeconomic group, compared to the higher socioeconomic group. The test for differences in rural vs. urban concentration indices for high blood pressure, overweight/obesity, alcohol consumption, and tobacco use were statistically significant in all the health indicators ( < 0.05). An effective intervention should incorporate a high-risk approach to terminate risk distribution by directing resources to key population women. To improve the benefit to risk ratio and enhance the cost effectiveness of preventive health programmes, it is paramount to understand the worth of equity-based strategies. Integrating equity elements to interventions is a key measure toward ensuring that policies and programmes meet their milestones. Government should strengthen living standards, literacy and healthcare system to curtail the increasing prevalence of the risk factors of NCDs.
了解与非传染性疾病(NCDs)风险因素相关的社会经济不一致情况,有助于指导有效的干预措施,以终止其持续发生。我们调查了撒哈拉以南非洲国家女性中高血压、超重/肥胖、饮酒和吸烟的患病率,并按财富五分位数进行了比较。本研究纳入了2008/09年至2017年期间在33个撒哈拉以南非洲国家进行的当前人口与健康调查(DHS)中的454,080名育龄妇女(15 - 49岁)。结果变量为高血压、超重/肥胖、饮酒和吸烟。研究了不同财富五分位数水平下非传染性疾病风险因素的患病率及样本特征。此外,使用集中指数(CI)和考虑城乡差异的洛伦兹曲线来衡量社会经济不平等。高血压和超重/肥胖的患病率分别为1.2 - 17.3%和6.7 - 44.5%,财富五分位数差异显著。此外,饮酒患病率为4.1 - 47.3%,吸烟率为0.3 - 9.9%。高血压的总体患病率为5.5%,超重/肥胖约占23.1%,饮酒者和吸烟者分别为23.9%和2.4%。与社会经济地位较低的群体相比,社会经济地位较高的群体在高血压(CI = 0.1352,< 0.001)、超重/肥胖(CI = 0.2285,< 0.001)和饮酒(CI = 0.0278,< 0.001)方面的社会经济不平等显著更大。相比之下,与社会经济地位较高的群体相比,社会经济地位较低的群体吸烟率( = -0.2551,< 0.001)显著更高。在所有健康指标中,高血压、超重/肥胖、饮酒和吸烟的城乡集中指数差异检验均具有统计学意义(< 0.05)。有效的干预措施应采用高风险方法,通过将资源导向关键人群女性来终止风险分布。为了提高效益风险比并增强预防性健康计划的成本效益,理解基于公平的策略的价值至关重要。将公平要素纳入干预措施是确保政策和计划实现其目标的关键措施。政府应提高生活水平、识字率并加强医疗保健系统,以减少非传染性疾病风险因素患病率的上升。