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

BACKGROUND: Non-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 healt...

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Autores principales: Azul, Anabela Marisa, Almendra, Ricardo, Quatorze, Marta, Loureiro, Adriana, Reis, Flávio, Tavares, Rui, Mota-Pinto, Anabela, Cunha, António, Rama, Luís, Malva, João Oliveira, Santana, Paula, Ramalho-Santos, João
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422758/
https://www.ncbi.nlm.nih.gov/pubmed/34488709
http://dx.doi.org/10.1186/s12889-021-11661-4
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author Azul, Anabela Marisa
Almendra, Ricardo
Quatorze, Marta
Loureiro, Adriana
Reis, Flávio
Tavares, Rui
Mota-Pinto, Anabela
Cunha, António
Rama, Luís
Malva, João Oliveira
Santana, Paula
Ramalho-Santos, João
author_facet Azul, Anabela Marisa
Almendra, Ricardo
Quatorze, Marta
Loureiro, Adriana
Reis, Flávio
Tavares, Rui
Mota-Pinto, Anabela
Cunha, António
Rama, Luís
Malva, João Oliveira
Santana, Paula
Ramalho-Santos, João
author_sort Azul, Anabela Marisa
collection PubMed
description BACKGROUND: Non-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. METHODS: We 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. RESULTS: Men 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. CONCLUSIONS: Metabolic 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11661-4.
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spelling pubmed-84227582021-09-09 Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study Azul, Anabela Marisa Almendra, Ricardo Quatorze, Marta Loureiro, Adriana Reis, Flávio Tavares, Rui Mota-Pinto, Anabela Cunha, António Rama, Luís Malva, João Oliveira Santana, Paula Ramalho-Santos, João BMC Public Health Research Article BACKGROUND: Non-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. METHODS: We 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. RESULTS: Men 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. CONCLUSIONS: Metabolic 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11661-4. BioMed Central 2021-09-06 /pmc/articles/PMC8422758/ /pubmed/34488709 http://dx.doi.org/10.1186/s12889-021-11661-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Azul, Anabela Marisa
Almendra, Ricardo
Quatorze, Marta
Loureiro, Adriana
Reis, Flávio
Tavares, Rui
Mota-Pinto, Anabela
Cunha, António
Rama, Luís
Malva, João Oliveira
Santana, Paula
Ramalho-Santos, João
Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
title Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
title_full Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
title_fullStr Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
title_full_unstemmed Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
title_short Unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
title_sort unhealthy lifestyles, environment, well-being and health capability in rural neighbourhoods: a community-based cross-sectional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8422758/
https://www.ncbi.nlm.nih.gov/pubmed/34488709
http://dx.doi.org/10.1186/s12889-021-11661-4
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