Non-communicable diseases among low income adults in rural coastal communities in Eastern Sabah, Malaysia

Abstract

Background Rural coastal communities in Sabah are still overly represented in the hardcore poor economic status. The aim of this study was to determine the prevalence of hypertension, diabetes mellitus and hypercholesterolemia among adults, in relation to economic status. Methods A cross-sectional study using stratified random sampling was conducted in seven coastal villages in Semporna, Sabah: Kabogan Laut, Salimbangun, Pekalangan, Pokas, Tampi-Tampi Timbayan, Sum Sum and Selinggit. Socio-demographic data were obtained via interviewer administered questionnaires in Sabah Malay creole. Anthropometric measurements, blood pressure, fasting blood glucose and blood lipids were obtained. Results A total of 330 adults (133 males, 197 females) completed the study. Mean age was 43.7 ± 15.8 years. Most participants (87%) were living below the Poverty Line Income. Median per capita household income was RM83.33/month (≈ USD20/month). The number of newly diagnosed cases of hypercholesterolemia was 40.6%, diabetes mellitus was 5.8%, and hypertension was 24.5%. Adults from the hardcore poor economic status (household income ≤RM760/month (≈USD183/month) were the most represented in those who did not have a blood pressure, blood sugar and blood lipids check in the 12 months preceding the study (Χ 2 , p < 0.01). Adults from hardcore poor economic status were also the most represented in undiagnosed hypertension and uncontrolled blood pressure among those diagnosed (Χ 2 , p = 0.013). Among diabetics from the hardcore poor group, the undiagnosed fasting blood glucose was 11.2 ± 4.5 compared to 5.1 ± 0.6 mmol/L for diagnosed diabetics (p < 0.001). Among hypercholesterolemics from the hardcore poor group, total cholesterol and LDL cholesterol values were significantly higher in the undiagnosed group compared to the diagnosed group (p < 0.001). Conclusion Many people in this rural coastal community were unaware that they had high cholesterol level (40.6%) and elevated blood pressure (24.5%). Routine health check is not common among low income adults in rural coastal communities in Semporna. The findings suggest public health initiatives should emphasize access to and the necessity of routine health checks for those aged 40 years.

Relationship between Physical Activity and Cardiovascular Risk Factors: A Cross-Sectional Study among Low-Income Housewives in Kuala Lumpur

“…Low socioeconomic status, which includes schooling, income, and jobs, is often linked to poor health [ 4 , 31 , 32 , 33 ]. Adults in Sabah with lower levels of education are more likely to have hypertension and hypercholesterolemia, according to a study in 2019 [ 31 ]. Additionally, people who have a lower household income and have never been diagnosed with noncommunicable disorders have slightly higher systolic blood pressure, overall cholesterol, LDL cholesterol, and fasting blood glucose.…”

Health status, healthcare utilisation, and quality of life among the coastal communities in Sabah

“…[ 27 ] In addition, in a previous report, there were 30% to 60% of people in rural coastal areas in Sabah who were unaware that they had several non-communicable diseases and were at risk for developing cardiovascular diseases. [ 10 ] This appeared to be mainly due to low awareness of routine health check-up and poor access to healthcare services particularly in the rural coastal areas. [ 10 ]…”

“…[ 10 ] This appeared to be mainly due to low awareness of routine health check-up and poor access to healthcare services particularly in the rural coastal areas. [ 10 ]…”

“…The lack of progress in healthcare facilities and other associated resources has resulted in difficult access to these services, low health awareness and health inequalities between coastal, non-coastal and urban population. [ 10 , 11 ] These, in turn, can result in poor health and poor quality of life among the coastal communities, which may lead to numerous negative health consequences.…”

“…[ 22 ] Even though public health facilities are available, they are limited and might not reach those in need due to insufficient infrastructure to access the services. [ 10 ] In addition, Sabah is facing a high rate of poverty [ 10 ] and an large influx of stateless and undocumented people in its coastal areas. [ 23 ] Because of these factors, the coastal communities in Sabah are facing various health and healthcare challenges.…”