Abstract
Background: The global escalating prevalence of lifestyle-related non-communicable diseases places a significant burden on health systems. Chronic diseases of lifestyle (CDL) are a group of diseases that share similar modifiable risk factors that can result in long-term disease processes. Considering the socio-behavioral-metabolic risk profiles of communities and risk factors predictive of the presence of CDL can assist in the development of focused and effective community-based prevention, intervention, and treatment programs for CDL.Aim: To determine the socio-behavioral-metabolic risk profiles and identify associated factors for the following CDL: obesity, cardiovascular disease, hypertension, and type 2 diabetes mellitus in rural and urban communities in central South Africa.Methodology: This cross-sectional study included adults aged 25–65 years in the rural Southern Free State and urban Mangaung. Social determinants, behavioral and metabolic risk factors, and inflammatory biomarkers for CDL were determined.Results: In total, 575 rural (mean age: 42 years; 71% female) and 429 urban (mean age: 44 years; 76% female) participants were included in the study. More than 20% of participants in both communities reported being previously diagnosed with cardiovascular diseases; with reported hypertension and diabetes mellitus more prevalent among rural participants. Insufficient intake of fruit and vegetables, alcohol use, and high blood pressure were among the top five risk factors in both communities. Physical inactivity ranked among the top two risk factors in the urban community; while alcohol and tobacco use was significantly higher in the rural community. Fibrinogen was the most prevalent inflammatory marker in both communities (32.9 rural vs. 48.3% urban). High sensitivity C-reactive protein (Hs-CRP), only available for rural participants, was high with increased levels in more than 80% of participants. In both communities, being female, having high blood pressure and increased fibrinogen levels were associated with obesity.Conclusion: This study illustrated the high prevalence of socio-behavioral-metabolic risk factors for CDL, and identified similarities and distinct differences in the risk profiles of rural and urban communities. Considering the CDL risk profiles of communities can assist in prioritizing health needs and contribute to the development of tailor-made community-based primary health care prevention, intervention, and health promotion programs.
Highlights
Non-communicable diseases (NCDs), called chronic diseases, are a group of conditions that account for millions of deaths globally each year [1]
The urban part of the study was conducted in the service area of the Mangaung University Community Partnership Programme (MUCPP) clinic and a stratified proportional cluster sample of the communities in this service area was selected for the study
A total number of 1,004 (575 rural and 429 urban) participants, between 25 and 65 years adhered to the study criteria and were included in the study
Summary
Non-communicable diseases (NCDs), called chronic diseases, are a group of conditions that account for millions of deaths globally each year [1]. The World Health Organization’s (WHO) country-specific profiles for NCDs [3] illustrate the escalating prevalence of modifiable lifestyle/behavioral risk factors in South Africa, that can lead to physiological and metabolic changes (obesity, high blood pressure, hyperglycemia, and hyperlipidemia) and result in chronic diseases of lifestyle (CDL), including hypertension, chronic lung diseases, cancer, and diabetes. Attention has shifted from focusing only on adult lifestyle-related risk factors as a cause for maintaining the risk cycle for CDL to adopting a lifecourse approach that acknowledges the influence of early life experiences on adult health and mortality. The global escalating prevalence of lifestyle-related non-communicable diseases places a significant burden on health systems. Considering the socio-behavioral-metabolic risk profiles of communities and risk factors predictive of the presence of CDL can assist in the development of focused and effective community-based prevention, intervention, and treatment programs for CDL
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