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. 2014 Jul 29;11(7):e1001683.
doi: 10.1371/journal.pmed.1001683. eCollection 2014 Jul.

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

Johanna Riha  1 , Alex Karabarinde  2 , Gerald Ssenyomo  2 , Steven Allender  3 , Gershim Asiki  2 , Anatoli Kamali  4 , Elizabeth H Young  1 , Manjinder S Sandhu  1 , Janet Seeley  4
Affiliations

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

Johanna Riha et al. PLoS Med. .

Abstract

Background: 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.

Methods and findings: 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).

Conclusions: 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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Map of districts within Uganda and sub-counties within Kalungu District.
Figure 2
Figure 2. The main road in study villages in the lowest and highest urbanicity quartiles, Kyamulibwa, Uganda, 2011.
(A) Village in the lowest urbanicity quartile; (B) village in the highest urbanicity quartile.
See this image and copyright information in PMC

Comment in

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