Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study

Abstract

Background Non-communicable diseases are a leading cause of health loss worldwide, in part due to unhealthy lifestyles. Metabolic-based diseases are rising with an unhealthy body-mass index (BMI) in rural areas as the main risk factor in adults, which may be amplified by wider determinants of health. Changes in rural environments reflect the need of better understanding the factors affecting the self-ability for making balanced decisions. We assessed whether unhealthy lifestyles and environment in rural neighbourhoods are reflected into metabolic risks and health capability. Methods We conducted a community-based cross-sectional study in 15 Portuguese rural neighbourhoods to describe individuals’ health functioning condition and to characterize the community environment. We followed a qualitatively driven mixed-method design to gather information about evidence-based data, lifestyles and neighbourhood satisfaction (incorporated in eVida technology), within a random sample of 270 individuals, and in-depth interviews to 107 individuals, to uncover whether environment influence the ability for improving or pursuing heath and well-being. Results Men showed to have a 75% higher probability of being overweight than women (p-value = 0.0954); and the reporting of health loss risks was higher in women (RR: 1.48; p-value = 0.122), individuals with larger waist circumference (RR: 2.21; IC: 1.19; 4.27), overweight and obesity (RR: 1.38; p-value = 0.293) and aged over 75 years (RR: 1.78; p-value = 0.235; when compared with participants under 40 years old). Metabolic risks were more associated to BMI and physical activity than diet (or sleeping habits). Overall, metabolic risk linked to BMI was higher in small villages than in municipalities. Seven dimensions, economic development, built (and natural) environment, social network, health care, demography, active lifestyles, and mobility, reflected the self-perceptions in place affecting the individual ability to make healthy choices. Qualitative data exposed asymmetries in surrounding environments among neighbourhoods and uncovered the natural environment and natural resources specifies as the main value of rural well-being. Conclusions Metabolic risk factors reflect unhealthy lifestyles and can be associated with environment contextual-dependent circumstances. People-centred approaches highlight wider socioeconomic and (natural) environmental determinants reflecting health needs, health expectations and health capability. Our community-based program and cross-disciplinary research provides insights that may improve health-promoting changes in rural neighbourhoods.

The Impact of Physical Activity Levels and Functional Fitness Status on the Quality of Life Perceived by Older Adults Living in Rural and Urban Areas: The Portuguese Inland Case

“…In the present study, the rural older participants showed better HRQoL than the urban older adults residents. A Portuguese study with a similar population presented contrary results, with older people living in rural areas presenting a lower perceived HRQoL compared to urban residents [ 67 ]. The authors mentioned that the low level of education and the lack of systematic (rather than casual) PA may explain some of the reported results.…”

Prevalencia de enfermedades no transmisibles y factores de riesgo en población rural de San Luis, Argentina

“…Encontramos un alto porcentaje de participantes (96,5%) que refirieron sentir estrés a veces, con frecuencia o en forma permanente en el trabajo, el hogar o por motivos económicos; si bien dicha categoría conceptual resulta amplia en el sentido de contener una variedad de sentimientos posibles, llama la atención su magnitud cercana a la totalidad de la población estudiada. La proporción de personas con ansiedad o depresión fue superior a la reportada para localidades urbanas de Argentina 3 y similar a la de un estudio en población rural de Portugal 22 .…”

“…Encontramos un alto porcentaje de participantes (96,5%) que refirieron sentir estrés a veces, con frecuencia o en forma permanente en el trabajo, el hogar o por motivos económicos; si bien dicha categoría conceptual resulta amplia en el sentido de contener una variedad de sentimientos posibles, llama la atención su magnitud cercana a la totalidad de la población estudiada. La proporción de personas con ansiedad o depresión fue superior a la reportada para localidades urbanas de Argentina (3) y similar a la de un estudio en población rural de Portugal (22) . Cabe subrayar el peso que tuvo el centro de salud a la hora de requerir consulta médica en esta población, señalado como lugar preferencial frente a emergencias médicas en el 69,1%; este perfil difiere del de un estudio en población mayoritariamente urbana de Argentina, que encontró que el lugar donde se acudía con mayor frecuencia ante la necesidad de atención fue el hospital (23) .…”

Influence of living settings on physical activity levels and volition in exercise in male and female university students

“…Sedentary behavior may impact significantly on health and fitness status. Indeed, low levels of physical activity constitute risk factor for the onset of different of non-communicable diseases and may be associated with environment contextual-dependent circumstances [ 21 ]. Moreover, a recent study highlighted a ubiquitous change in perceived opportunities for physical activity.…”