Quantifying urbanisation as a risk factor for non-communicable disease

Abstract

Aim of this study was to investigate the poorly understood relationship between the process of urbanization and non-communicable diseases (NCDs) in Sri Lanka using a multi-component, quantitative measure of urbanicity.NCD prevalence data were taken from the Sri Lankan Diabetes and Cardiovascular Study comprising a representative sample of people from seven of the nine provinces in Sri Lanka (n=4,485/5,000; response rate=89.7%). We constructed a measure of the urban environment for seven areas using a seven-item scale based on data from study clusters to develop an ―urbanicity&rdquo; scale. The items were population size, population density, and access to markets, transportation, communications/media, economic factors, environment/sanitation, health, education, and housing quality. Linear and logistic regression models were constructed to examine the relationship between urbanicity and chronic disease risk factors.Among men, urbanicity was positively associated with physical inactivity (OR: 3.22; 2.27 &ndash; 4.57), high body mass index (OR: 2.45; 95% CI: 1.88 &ndash; 3.20) and diabetes mellitus (OR: 2.44; 95% CI: 1.66 &ndash; 3.57). Among women, too, urbanicity was positively associated with physical inactivity (OR: 2.29; 95% CI: 1.64 &ndash; 3.21), high body mass index (OR: 2.92;95% CI: 2.41 &ndash; 3.55) and diabetes mellitus (OR: 2.10; 95% CI: 1.58 &ndash; 2.80).There is a clear relationship between urbanicity and common modifiable risk factors for chronic disease in a representative sample of Sri Lankan adults.<br /