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Quantifying Urbanization as a Risk Factor for Noncommunicable Disease

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Abstract

The aim of this study was to investigate the poorly understood relationship between the process of urbanization and noncommunicable diseases (NCDs) in Sri Lanka using a multicomponent, 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 7-item scale based on data from study clusters to develop an “urbanicity” 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 (odds ratio [OR] = 3.22; 2.27–4.57), high body mass index (OR = 2.45; 95% CI, 1.88–3.20) and diabetes mellitus (OR = 2.44; 95% CI, 1.66–3.57). Among women, too, urbanicity was positively associated with physical inactivity (OR = 2.29; 95% CI, 1.64–3.21), high body mass index (OR = 2.92; 95% CI, 2.41–3.55), and diabetes mellitus (OR = 2.10; 95% CI, 1.58 – 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.

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Authors and Affiliations

  1. British Heart Foundation Health Promotion Research Group, Department of Public Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK

    Steven Allender & Kremlin Wickramasinghe

  2. World Health Organization Collaborating Centre for Obesity Prevention, Deakin University, Melbourne, Australia

    Steven Allender

  3. Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford, UK

    Michael Goldacre

  4. Oxford Centre for Diabetes, Endocrinology, and Metabolism, University of Oxford, Oxford, UK

    David Matthews

  5. Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka

    Prasad Katulanda

Authors
  1. Steven Allender
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  2. Kremlin Wickramasinghe
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  3. Michael Goldacre
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  4. David Matthews
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  5. Prasad Katulanda
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Correspondence to Kremlin Wickramasinghe.

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Allender, S., Wickramasinghe, K., Goldacre, M. et al. Quantifying Urbanization as a Risk Factor for Noncommunicable Disease. J Urban Health 88, 906–918 (2011). https://doi.org/10.1007/s11524-011-9586-1

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  • DOI: https://doi.org/10.1007/s11524-011-9586-1

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