Rural, Urban and Migrant Differences in Non-Communicable Disease Risk-Factors in Middle Income Countries: A Cross-Sectional Study of WHO-SAGE Data

Abstract

BackgroundUnderstanding how urbanisation and rural-urban migration influence risk-factors for non-communicable disease (NCD) is crucial for developing effective preventative strategies globally. This study compares NCD risk-factor prevalence in urban, rural and migrant populations in China, Ghana, India, Mexico, Russia and South Africa.MethodsStudy participants were 39,436 adults within the WHO Study on global AGEing and adult health (SAGE), surveyed 2007–2010. Risk ratios (RR) for each risk-factor were calculated using logistic regression in country-specific and all country pooled analyses, adjusted for age, sex and survey design. Fully adjusted models included income quintile, marital status and education.ResultsRegular alcohol consumption was lower in migrant and urban groups than in rural groups (pooled RR and 95%CI: 0.47 (0.31–0.68); 0.58, (0.46–0.72), respectively). Occupational physical activity was lower (0.86 (0.72–0.98); 0.76 (0.65–0.85)) while active travel and recreational physical activity were higher (pooled RRs for urban groups; 1.05 (1.00–1.09), 2.36 (1.95–2.83), respectively; for migrant groups: 1.07 (1.0 -1.12), 1.71 (1.11–2.53), respectively). Overweight, raised waist circumference and diagnosed diabetes were higher in urban groups (1.19 (1.04–1.35), 1.24 (1.07–1.42), 1.69 (1.15–2.47), respectively). Exceptions to these trends exist: obesity indicators were higher in rural Russia; active travel was lower in urban groups in Ghana and India; and in South Africa, urban groups had the highest alcohol consumption.ConclusionMigrants and urban dwellers had similar NCD risk-factor profiles. These were not consistently worse than those seen in rural dwellers. The variable impact of urbanisation on NCD risk must be considered in the design and evaluation of strategies to reduce the growing burden of NCDs globally.

Inequalities in smoking prevalence: a missed opportunity for tobacco control in Pakistan

“…However, the trend was opposite a decade ago when the prevalence of smoking was reported more in urban areas (15.2% as compared to 13.7%) in a national survey (25). Similar trends have been seen in China, Ghana and India (26). The design of tobacco control policies in Pakistan may be a major contributing factor for causing this shift of smoking burden to rural areas.…”

“…In multivariate analysis for both sexes, being in one of the two older age groups (30-39, 40-49) increased odds of cigarette smoking compared with the youngest age group (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Twice as many rural women smoked cigarettes compared with urban women (1.6% compared with 0.8%), however in multivariate analyses, geography was not significantly associated with cigarette smoking in either sex [ Table 4].…”

High rate of diabetes in the Asia-Pacific Island: Possible role of rapid urbanization – A hospital based study

“…16 Similar observations were reported in other Pacific, African and Caribbean countries. 13,[17][18] In contrast, Lin et al 19 reported high prevalence of diabetes in both rural and urban areas in Pacific Tongans. This suggests adoption of new lifestyle which is closely associated with urbanisation in certain countries might not be applicable to some indigenous populations who are at high risk of diabetes irrespective of the rural-urban status.…”

“…Kimbe town has witnessed an exponential rise of population by 500% in 30 years and is likely to quadruple the current figure by 2020 in view of increased industrial and mining activities which are linked to rural-urban migration. 9,12,13 The significance of this finding suggests rapid expansion of the population may have impact on in-50 creasing the risk of diabetes likely related to lifestyle changes related to modernisation. Findings of many studies have shown clearly a positive rural-urban gradient in prevalence of diabetes.…”

Dyslipidemia Among the Elderly in Slums of West Delhi

“…Rapid urbanization, rural-tourban migration, poor dietary habits, physical inactivity, sociocultural factors, and genetic predisposition all contribute to dyslipidemia [5]. The WHO Study on Global Aging and Adult Health carried out among 39,436 adults during 2007-2010 revealed that rural-urban migrants had a similar risk factor profile for non-communicable disease to the urban group, suggesting that exposure to urban environments may promote assimilation of health behavior regardless of previous life experiences [6]. This study was carried out to assess the prevalence of dyslipidemia among the elderly in slums of West Delhi.…”