Christian Aaron Kobina, Daniel Egerson, Sanuade Olutobi Adekunle
Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon- Accra, Accra, Ghana.
Department of Population Health Sciences, Division of Health System Innovation and Research Spencer Fox Eccles School of Medicine University of Utah, Salt Lake City, UT, USA.
BMC Public Health. 2025 Jul 23;25(1):2535. doi: 10.1186/s12889-025-23769-y.
Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment.
Using data from the 2017 Zambia WHO STEPS survey (N = 4,302 adults, mean age: 36.57 years), Latent Class Analysis identified NCD risk profiles, and multinomial logistic regression assessed their associations with socioeconomic determinants.
Three NCD risk groups emerged: Low-Risk (12.0%), Intermediate-Risk (64.3%), and High-Risk (23.7%). The Low-Risk group maintained healthy lifestyles. The Intermediate-Risk group, the most prevalent, showed borderline metabolic indicators and occasional unhealthy behaviours. The High-Risk group exhibited multiple risk factors, including obesity, hypertension, diabetes, and substance use. Males had 22.8 times higher odds of being in the High-Risk group than females. Surprisingly, higher education increased the odds of being in the Moderate- and High-Risk groups.
NCD prevention in Zambia requires risk-stratified strategies: primary prevention for Intermediate-Risk groups and intensive intervention for High-Risk populations. Critical policy actions include taxing tobacco, alcohol, and unhealthy foods; expanding universal screening; integrating NCD care into primary health systems; and addressing urbanization, cultural practices, and healthcare disparities.
非传染性疾病是赞比亚面临的一项公共卫生挑战。这是由经济转型、城市化和生活方式变化所驱动的。本研究探讨了非传染性疾病如何聚集以及与教育、收入和就业等社会经济因素之间的关系。
利用2017年赞比亚世卫组织全球健康危险因素调查（全球健康行为危险因素监测）的数据（N = 4302名成年人，平均年龄：36.57岁），潜在类别分析确定了非传染性疾病风险概况，多项逻辑回归评估了它们与社会经济决定因素的关联。
出现了三个非传染性疾病风险组：低风险组（12.0%）、中风险组（64.3%）和高风险组（23.7%）。低风险组保持健康的生活方式。最普遍的中风险组显示出临界代谢指标和偶尔的不健康行为。高风险组表现出多种风险因素，包括肥胖、高血压、糖尿病和药物使用。男性处于高风险组的几率比女性高22.8倍。令人惊讶的是，高等教育增加了处于中风险组和高风险组的几率。
赞比亚的非传染性疾病预防需要采取风险分层策略：对中风险组进行一级预防，对高风险人群进行强化干预。关键的政策行动包括对烟草、酒精和不健康食品征税；扩大全民筛查；将非传染性疾病护理纳入初级卫生系统；以及应对城市化、文化习俗和医疗保健差距。
