Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study

BMC Public Health

João Oliveira Malva¹  Flávio Reis²  João Ramalho-Santos³  Anabela Marisa Azul⁴  Rui Tavares⁴  Adriana Loureiro⁵  Paula Santana⁶  Ricardo Almendra⁶  Marta Quatorze⁷  Anabela Mota-Pinto⁸  Luís Rama⁹  António Cunha^1,10 

[1] Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789, Coimbra, Portugal;Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789, Coimbra, Portugal;Institute of Pharmacology & Experimental Therapeutics, Faculty of Medicine, University of Coimbra, 3030-370, Coimbra, Portugal;Ageing@Coimbra, EIP on AHA Reference Site, Coimbra, Portugal;Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789, Coimbra, Portugal;Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789, Coimbra, Portugal;Institute of Pharmacology & Experimental Therapeutics, Faculty of Medicine, University of Coimbra, 3030-370, Coimbra, Portugal;Clinical Academic Center of Coimbra (CACC), 3030-370, Coimbra, Portugal;Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504, Coimbra, Portugal;Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789, Coimbra, Portugal;Department of Life Sciences (DCV), Faculty of Sciences and Technology, University of Coimbra, 3000-456, Coimbra, Portugal;Center for Neuroscience and Cell Biology (CNC), University of Coimbra, 3004-504, Coimbra, Portugal;Center for Innovative Biomedicine and Biotechnology (CIBB), University of Coimbra, 3030-789, Coimbra, Portugal;University of Coimbra, Institute for Interdisciplinary Research (IIIUC), 3030-789, Coimbra, Portugal;Centre of Studies in Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530, Coimbra, Portugal;Centre of Studies in Geography and Spatial Planning (CEGOT), Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530, Coimbra, Portugal;Department of Geography and Tourism, Faculty of Arts and Humanities, Colégio de São Jerónimo, University of Coimbra, 3004-530, Coimbra, Portugal;Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789, Coimbra, Portugal;Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, 3030-789, Coimbra, Portugal;CIMAGO-Center for Research in the Environment, Genetics and Oncobiology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal;Faculty of Sport Sciences and Physical Education, University of Coimbra, 3040-256, Coimbra, Portugal;IPN-Laboratory of Automatics and Systems, Pedro Nunes Institute, 3030-199, Coimbra, Portugal;Ageing@Coimbra, EIP on AHA Reference Site, Coimbra, Portugal;

关键词: Non-communicable diseases;    Healthy lifestyles;    Health loss;    Health capability;    Qualitative driven mixed-methods;    Participatory community-based research;    Built environment;    Natural environment;    Rural areas;   

DOI  :  10.1186/s12889-021-11661-4

来源: Springer

【 摘 要 】

BackgroundNon-communicable diseases are a leading cause of health loss worldwide, in part due to unhealthy lifestyles. Metabolic-based diseases are rising with an unhealthy body-mass index (BMI) in rural areas as the main risk factor in adults, which may be amplified by wider determinants of health. Changes in rural environments reflect the need of better understanding the factors affecting the self-ability for making balanced decisions. We assessed whether unhealthy lifestyles and environment in rural neighbourhoods are reflected into metabolic risks and health capability.MethodsWe conducted a community-based cross-sectional study in 15 Portuguese rural neighbourhoods to describe individuals’ health functioning condition and to characterize the community environment. We followed a qualitatively driven mixed-method design to gather information about evidence-based data, lifestyles and neighbourhood satisfaction (incorporated in eVida technology), within a random sample of 270 individuals, and in-depth interviews to 107 individuals, to uncover whether environment influence the ability for improving or pursuing heath and well-being.ResultsMen showed to have a 75% higher probability of being overweight than women (p-value = 0.0954); and the reporting of health loss risks was higher in women (RR: 1.48; p-value = 0.122), individuals with larger waist circumference (RR: 2.21; IC: 1.19; 4.27), overweight and obesity (RR: 1.38; p-value = 0.293) and aged over 75 years (RR: 1.78; p-value = 0.235; when compared with participants under 40 years old). Metabolic risks were more associated to BMI and physical activity than diet (or sleeping habits). Overall, metabolic risk linked to BMI was higher in small villages than in municipalities. Seven dimensions, economic development, built (and natural) environment, social network, health care, demography, active lifestyles, and mobility, reflected the self-perceptions in place affecting the individual ability to make healthy choices. Qualitative data exposed asymmetries in surrounding environments among neighbourhoods and uncovered the natural environment and natural resources specifies as the main value of rural well-being.ConclusionsMetabolic risk factors reflect unhealthy lifestyles and can be associated with environment contextual-dependent circumstances. People-centred approaches highlight wider socioeconomic and (natural) environmental determinants reflecting health needs, health expectations and health capability. Our community-based program and cross-disciplinary research provides insights that may improve health-promoting changes in rural neighbourhoods.

【 授权许可】

CC BY