Spatial analysis of the prevalence of obesity and overweight among women in Ghana

Abstract

ObjectiveIdentifying hot spots for the overweight aids in effective public health interventions due to the associated public health burden and morbidities. This study, therefore aimed to explore and determine the spatial disparities in the overweight/obesity prevalence among women in Ghana. The study also aims at modelling the average body mass index (BMI) values using the spatial regression and the performance compared with the standard regression model.DesignThis is a cross-sectional study using data from the 2014 Ghana Demographic and Health Survey (GDHS).SettingThe study was set in Ghana.Participants and methodsData on 4393 non-pregnant women aged 15–49 years from the 2014 GDHS. Both global (Moran’s I) and the local indicators for spatial dependence were examined through the mapped BMI values across the country by clusters. An estimated spatial lag model was used to explain the spatial differences in the average body sizes of women.ResultsThe overall prevalence of overweight/obesity among reproductive women in Ghana was 35.4%, and this was highly prevalent among educated women (p<0.001), those from wealthy households (p<0.001) and dwelling in an urban setting (p<0.001). Significant clustering (Moran’s I=0.3145, p<0.01) of overweight/obesity was observed with hot spots (clustering) in Greater Accra, Central, Western and Ashanti regions. The spatial lag model was the best fit based on the Likelihood ratio test and the Akaike information criterion and Bayesian information criterion values. The mean age of women and household wealth were significant factors accounting for the increase in the average cluster body size (BMI) of women and the spatial differences.ConclusionThe prevalence of overweight/obesity was high and spatially clustered in the southern, middle and coastal regions. Geographic specific and effective public health interventions and strategies are needed to address the growing morbidity burden associated with the rise in the average body sizes of reproductive women.

Small area variations and factors associated with blood pressure and body-mass index in adult women in Accra, Ghana: Bayesian spatial analysis of a representative population survey and census data

“…Our estimate of the BMI of women in Accra in 2010 was similar to what was found in the 2006 WHO STEPs survey [ 37 ] and was higher than the estimated national average for Ghanaian women at that time [ 7 ], which is consistent with the evidence of higher BMI in urban compared with rural areas in Ghana [ 18 ] and SSA [ 11 ]. Similarly, the prevalence of women with uncontrolled hypertension in Accra was slightly higher than the crude prevalence among women in Ghana [ 5 ].…”

“…Higher SES and literacy were associated with higher BMI and lower BP. This divergent trend between BP and BMI has been found in other studies in SSA [ 10 , 15 – 18 , 38 – 41 ]. Higher SES in SSA may lead to a higher caloric consumption and less energy expenditure in work and commute (e.g., commuting by private car [ 42 ]) that are risk factors for elevated BMI [ 15 , 43 ].…”

“…Previous research has highlighted urban–rural differences in BMI and BP in SSA and individual socioeconomic determinants and inequalities [ 9 – 11 , 15 – 17 ]. In addition, a previous study spatially modelled overweight and obesity for women across subregions in Ghana [ 18 ]; however, there is very limited information on within-city spatial variations in BMI and BP at the small area level in SSA. We used data from a representative health survey of adult women’s health in Accra, Ghana and a national census to understand factors associated with BMI and BP and map the predicted levels across census enumeration areas (EAs) within the Accra Metropolitan Area (AMA).…”

Prevalence and correlates of overweight and obesity among under-five children in Egypt

“…This is a worry for public health due to the risk of maintaining overnutrition status in adulthood together with the several negative consequences. The study also found that a child's age (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37), birth weight (greater than 4 kg), consumption of protein foods, and mothers' wealth status are signi cantly associated with the risk of overweight and obesity among children under-ve years in Egypt. These ndings indicate the need for early and urgent strategies to mitigate childhood overnutrition in Egypt.…”

Effects of social determinants of health on obesity among urban women of reproductive age

“…Indeed, a country such as Ghana recorded as high as 65% increase in obesity during the study period [2]. Other studies also observed alarming trends in obesity among women of reproductive age in the African region (8-9). There is a need for deliberate policies by governments to address the problem.…”