Place inequalities and social determinants of non-communicable disease multimorbidity in Ghana

Authors: Kilian Atuoye*, University of Toronto - Mississauga, Vincent Kuuire, University of Toronto - Mississauga
Topics: Health and Medical, Cultural and Political Ecology
Keywords: non-communicable diseases, multimorbidity, place inequalities, social determinants of health, SDGs, Ghana, SSA
Session Type: Virtual Paper
Day: 4/8/2021
Start / End Time: 9:35 AM / 10:50 AM
Room: Virtual 41
Presentation File: No File Uploaded


Abstract
The increasing burden of non-communicable diseases (NCDs) is a critical global public health concern. With complicated risk factors and multimorbidity particularly in sub-Saharan Africa where social gradient is inversely associated with non-communicable disease risks, contemporary research has embraced theoretical and analytical approaches that help unpack NCD burden. Using the social determinants of health framework, we examined the influence of place inequalities and individual level factors on NCD multimorbidity in Ghana by fitting multilevel multinomial regression models to primary data (n=1145). The study revealed prevalence of single NCD and multiple NCD at 15% and 4%, respectively. Place morphology alone explains 5.2% of the variance in NCD multimorbidity, with high neighborhood income inequality and good healthcare associated with lower risk of multiple NCDs (RRR=0.72, p≤0.001; and RRR=0.39, p≤0.05, respectively). The study also confirmed self rated health, lifestyle factors (physical activity, dietary choice outside home, and consumption of unhealthy food/drinks), socio-economic disparities and demographic factors (age, gender, and wealth) as predictors of NCD multimorbidity. The findings amplify the need for prioritization of structural inequalities at neighborhood level in global and national actions for NCDs in Ghana and similar context.

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