Geneva Health Forum 2024

NCD behavioural risk factors among the world’s bottom billion living in extreme poverty

Not scheduled

15m

Geneva

Oral presentation or scientific poster Migration, health and equity

Description

Objectives: Evidence is sparse on the prevalence of noncommunicable disease (NCD) behavioural risk factors such as physical inactivity, unhealthy diet, alcohol consumption and smoking among the ‘bottom billion’ of the world’s population living in extreme poverty, which limits efforts to efficiently target prevention programmes and meet the SDG target of a one third reduction in premature non-communicable disease mortality by 2030.
Methods: We conducted a cross-sectional analysis of nationally representative household surveys from 78 LMICs between 2000 and 2019 that represent 85% of people living in extreme poverty globally. We identify those living in extreme poverty by ordering individuals by their socioeconomic status proxied by a continuous household wealth index or self-reported household income, then applied the World Bank’s estimates of the proportion of each country’s population living in extreme poverty (<$2.15 per day) We pooled individual data using both sample and population weights, and calculated the proportion of those living in extreme poverty who at higher risk of an NCD due to one or more behavioural risk factors according to WHO guidelines. Specifically, low physical activity; an unhealthy diet low in fruit and vegetables; harmful consumption of alcohol; or smoking tobacco.
Results: Individuals living in extreme poverty are less likely to smoke or be physically inactive but more likely to have an unhealthy diet and consume harmful amounts of alcohol compared to more wealthier individuals in low- and middle-income countries (LMICs). By sex, men living in extreme poverty have considerably higher prevalence of smoking and drinking than women, and lower prevalence of being overweight and low physical activity. With country’s economic development (GDP per capita), there is positive gradient for BMI, overweight and low physical activity while no clear relationship for smoking, alcohol consumption or unhealthy diet.
Discussion: NCD prevention strategies should ensure they reach the poorest sections of the population because NCD behavioural risk factors are prevalent across the full socioeconomic spectrum, including those living in extreme poverty, within countries at all levels of economic development.