Tsekpetse Prince, Salu Samuel, Shiuma Joshua, Nambozo Brenda, Makoko Brian Tonny, Ahinkorah Bright Opoku
Department of Community and Public Health, Busitema University, Mbale, Uganda.
Department of Epidemiology and Biostatistics, Fred. N. Binka School of Public Health, University of Health and Allied, Hohoe, Ghana.
BMC Public Health. 2025 May 28;25(1):1973. doi: 10.1186/s12889-025-23238-6.
Overweight and obesity are more prevalent among urban than rural populations in Africa, yet evidence on these disparities specifically among men remains limited. This study examined the urban-rural disparities and associated factors in overweight/obesity among Ghanaian men aged 20-49.
We analysed data from the 2022 Ghana Demographic and Health Survey, with a total sample of 4,797 men aged 20-49 with valid BMI measurements. Overweight/obesity was defined as a BMI ≥ 25 kg/m². Data were analysed using Stata version 17.0. A multivariate nonlinear decomposition model assessed the contributions of sociodemographic characteristics to urban-rural disparities in overweight/obesity.
The prevalence of overweight/obesity was significantly higher among urban men (27.48%) than rural men (12.03%). Differences in sociodemographic characteristics explained 87% of the observed urban-rural disparities, with differences in wealth index explaining over half (77%) of the urban-rural differences in overweight/obesity. Factors associated with overweight/obesity included age, wealth index, marital status, and alcohol use, while smoking was protective. Among urban men, the odds of overweight/obesity were higher in those aged 30-34 years (AOR = 2.56; 95% CI: 1.37-4.79), 35-39 years (AOR = 2.86; 95% CI: 1.54-5.30), 40-44 years (AOR = 2.80; 95% CI: 1.56-5.03), and 45-49 years (AOR = 4.47; 95% CI: 2.20-9.07). Wealth was a strong predictor across settings; urban men in the richest quintile had an AOR of 17.37 (95% CI: 5.41-55.83), compared to 5.35 (95% CI: 2.76-10.34) among rural men. Alcohol use was significantly associated with overweight/obesity among urban men (AOR = 1.49; 95% CI: 1.09-2.04), while smoking showed a protective association in rural men (AOR = 0.33; 95% CI: 0.13-0.86).
This study shows that urban-rural disparities in overweight/obesity among men are largely driven by differences in wealth index. Socioeconomic differences should be considered when designing interventions to reduce overweight and obesity among men. Targeted strategies promoting healthy eating and physical activity, particularly among men in urban settings, are essential to address these disparities.
在非洲，超重和肥胖在城市人口中比农村人口中更为普遍，但关于这些差异，尤其是男性之间差异的证据仍然有限。本研究调查了20至49岁加纳男性超重/肥胖的城乡差异及相关因素。
我们分析了2022年加纳人口与健康调查的数据，总样本为4797名20至49岁且有有效BMI测量值的男性。超重/肥胖定义为BMI≥25kg/m²。使用Stata 17.0版本进行数据分析。一个多元非线性分解模型评估了社会人口学特征对超重/肥胖城乡差异的贡献。
城市男性超重/肥胖的患病率（27.48%）显著高于农村男性（12.03%）。社会人口学特征的差异解释了观察到的城乡差异的87%，其中财富指数的差异解释了超重/肥胖城乡差异的一半以上（77%）。与超重/肥胖相关的因素包括年龄、财富指数、婚姻状况和饮酒，而吸烟具有保护作用。在城市男性中，30至34岁（调整后比值比[AOR]=2.56；95%置信区间[CI]：1.37 - 4.79）、35至39岁（AOR = 2.86；95% CI：1.54 - 5.30）、40至44岁（AOR = 2.80；95% CI：1.56 - 5.03）和45至49岁（AOR = 4.47；95% CI：2.20 - 9.07）的男性超重/肥胖的几率更高。财富在所有环境中都是一个强有力的预测因素；最富有的五分之一城市男性的AOR为17.37（95% CI：5.41 - 55.83），而农村男性为5.35（95% CI：2.76 - 10.34）。饮酒与城市男性超重/肥胖显著相关（AOR = 1.49；95% CI：1.09 - 2.04），而吸烟在农村男性中显示出保护关联（AOR = 0.33；95% CI：0.13 - 0.86）。
本研究表明，男性超重/肥胖的城乡差异在很大程度上是由财富指数的差异驱动的。在设计减少男性超重和肥胖的干预措施时，应考虑社会经济差异。针对性地促进健康饮食和体育活动的策略，特别是在城市环境中的男性中，对于解决这些差异至关重要。
