Co-occurrence of Behavioral Risk Factors of Non-communicable Diseases and Social Determinants among Adults in Urban Centers of Southwestern Ethiopia in 2020: A Community-Based Cross-Sectional Study

BACKGROUND: Non-communicable diseases are priority global health problems. Smoking, harmful alcohol consumption, physical inactivity, and an unhealthy diet are four behavioral risk factors of these diseases. Studies in Ethiopia have focused on establishing associations between these factors and incommunicable diseases. OBJECTIVE: To assess the prevalence, co-occurrence, and social determinants of behavioral risk factors of non-communicable diseases among adults in urban centers of southwestern Ethiopia. METHODS: This study employed a cross-sectional design. Multistage sampling and the Kish method were used. The WHO’s STEPS instrument was used for data collection. Proportions and other descriptive measures are used to describe the data. Bivariate and multivariate logistic regression was run to assess associations. Associations between dependent and independent variables were determined using AORs, 95% CIs, and significance level of P=0.05. RESULTS: A total of 1,191 adults participated in the study for a 93.3% response rate. In sum, 4.8% of participants were smokers and 15.6% indulge in harmful drinking. Prevalence of physical inactivity was 60.45%, and 94.8% consumed insufficient fruit and vegetables. Regarding co-occurrence of these factors, 65.5% of participants had two or more behavioral risk factors. Female sex (AOR 3.1, 95% CI 1.8–5.5), no formal employment (AOR 1.9, 95% CI 1.02–3.7), greater wealth (AOR 2.44, 95% CI 1.1–5.1), not having a friend who does physical exercise (AOR 2.7, 95% CI 1.5–4.7), having friends who do not drink (AOR 0.20, 95% CI 0.09–0.44), and participating in community activities (AOR 2.95, 95% CI 1.4–6.0) were associated with co-occurrence of behavioral risk factors of non-communicable diseases. CONCLUSION: The prevalence and co-occurrence of behavioral risk factors of non-communicable diseases in the study area are alarming. Several factors were associated with co-occurrence of these factors. Community-based interventions have to be implemented considering family settings. Special focus has to be given to physical inactivity and fruit and vegetable consumption.