Abstract
Background: Practice of healthy lifestyle and regular medical screening are key cost-effective strategies for disease prevention. Regular medical screening promotes good health, as well as early diagnosis and treatment of diseases. Sustained healthy behavioral practices, regular medical screening and access to effective healthcare services, are therefore key determinants of good health and deterrents of morbidity and mortality. This study was aimed at assessing the practice of unhealthy behaviors, access to health care services and determinants of regular medical screening in a rural setting in the Niger-Delta region of Nigeria.
Methodology: A Cross-sectional study was employed, with use of multistage sampling method to recruit subjects from households in communities in Odukpani Local Government Area of Cross River State, Nigeria. Interviewer-administered questionnaire was used to obtain quantitative data on habits of smoking, alcohol consumption, physical exercise and regular medical screening as well as access to health care services. SPSS version 21.0 was used for data analysis.
Result: One hundred and eighty-five (185) subjects were surveyed, with a mean age of 35.7 ± 10.4 years. Regular alcohol consumption, smoking and inadequate physical exercise, was found in 152 (82.2%), 20, (10.8%) and 93, (50.3%) subjects, respectively. At least one of the three behavioral risk factors assessed, was found in 9 out of every 10 subjects (167, 90.3%). Eighty-three subjects (44.8%) had had medical screening within the last five years, while eighty (80,43.2%) had never done any screening before. The proportion of subjects that had screening done within the last 5 years was higher among those that were 40 years or older (56.9% vs. 39.4%, p=0.03). The commonest mode of procurement of health care services was through out-of-pocket (OOP) payment (178, 96.2%) and only seven subjects (7, 3.2%) were covered by health insurance.
Conclusion: There is a high prevalence of practice of unhealthy behaviors and irregular or non-medical screening for disease conditions. The predominance of OOP payment for health care services and inadequate health care facilities pose a huge barrier to healthcare access. It is imperative to intensify rural health education, widen the coverage of the National Health Insurance Scheme to cover rural communities and deepen its scope to include services like regular medical screening. The findings from this study should inform further studies to measure disease burden and determine the relationship between the lifestyle factors and disease patterns in Odukpani.
Keywords: Unhealthy lifestyle, medical screening,health care access, Niger Delta Region.
References
- Batty GD Kivimaki MGray LSmith GD Marmot MG Shipley MJ Cigarette smoking and site-specific cancer mortality: testing uncertain associations using extended follow-up of the original Whitehall study. Ann Oncol 2008;19 (5) 996- 1002
- Doll RHill AB Mortality in relation to smoking: ten years' observations of British doctors. Br Med J 1964;1 (5396) 1460- 1467
- Andersen LB Schnohr PSchroll MHein HO All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med 2000;160 (11) 1621- 1628
- Batty GD Shipley MJ Marmot M Smith GD Physical activity and cause-specific mortality in men: further evidence from the Whitehall study. Eur J Epidemiol 2001;17 (9) 863- 869
- Morris JN Heady JA Raffle PA Roberts CG Parks JW Coronary heart-disease and physical activity of work. Lancet 1953;265 (6796) 1111- 1120
- World Cancer Research Fund, Food, Nutrition, Physical Activity and the Prevention of Cancer: a Global Perspective. Washington, DC American Institute for Cancer Research.2007
- Gmel G Gutjahr ERehm J How stable is the risk curve between alcohol and all-cause mortality and what factors influence the shape? a precision-weighted hierarchical meta-analysis Eur J Epidemiol 2003;18 (7) 631- 642
- Marmot MG Rose G Shipley MJ Thomas BJ Alcohol and mortality: a U-shaped curve. Lancet 1981;1 (8220 pt 1) 580- 583
- Elisabeth Kvaavik, PhD; David Batty, PhD; Giske Ursin, MD, PhD; et al Rachel Huxley, DPhil; Catharine R. Gale, PhD Influence of Individual and Combined Health Behaviors on Total and Cause-Specific Mortality in Men and Women. The United Kingdom Health and Lifestyle Survey Arch Intern Med. 2010;170(8):711-718.
- Michael McGinnis, MD, MPP; William H. Foege, MD, MPH: Actual Causes of Death in the United States JAMA. 1993;270(18):2207-2212.
- Earl S. Ford, Manuela M. Bergmann; Janine Kröger; Anja Schienkiewitz; Cornelia Weikert; Heiner Boeing, Healthy Living Is the Best Revenge Findings From the European Prospective Investigation Into Cancerand Nutrition–Potsdam Study ARCH INTERN MED Vol169(No15) Aug10/24 2009 1335
- Katz, DL: Life and Death, Knowledge and Power: Why Knowing What Matters Is Not What's the Matter: Invited Commentary on “Healthy Living Is the Best Revenge” Arch Intern Med. 2009;169(15)
- Buse, Kent; Hawkes, Sarah (2015) Health in the sustainable development goals: ready for a paradigm shift? Globalization and Health 2015 11:!3
- UNDP (2015) United Nations Sustainable development goals: 17 goals to transform our world. Available at: http/www.un.org/sustainabledevelopment/health. accessed Jan 10th 2016
- Lopez A, Mathers C, Ezzati M, et al.: Global burden of disease and risk factors. Washington DC: Oxford University Press and World Bank, 2006.
- Ekpenyong, CE, Udokang, NE, Akpan, E.E, Samson: Double Burden, Non-Communicable Diseases And Risk Factors Evaluation In Sub Saharan Africa: The Nigerian Experience. European Journal of Sustainable Development (2012), 1, 2, 249-270
- Cooper R, Rotimi C, Ataman S, McGee D, Osotimehin B, Kadiri S, Muna W, Kingue S, Fraser H, Forrester T, Bennett F, Wilks R. The prevalence of hypertension in seven populations of west African origin.Am J Public Health. 1997 Feb;87(2):160-168
- Kruger HS, Christina S. Venter, Hester H. Vorster,, and Barrie M. Margetts. Physical Inactivity Is the Major Determinant of Obesity in Black Women in the North West Province, South Africa: The THUSA Study NUTRITION IN AFRICA ,18:422-427
- Bygbjerg IC. Double burden of non-communicable and infectious diseases in developing countries. Science. 2012 Sep 21;337(6101):1499-501.
- Bewley BR, Day I, Ide L (1972). Smoking by children in Great Britain. A review of the literature. London; Medical Research Council and Social Science Research Council.
- World Health Organization. WHO Report on the global tobacco epidemic, 2008. The MPOWER package 2008. Available from: http//www.who.int/tobacco,mpower/mpower_report. [Last accessed on March 2016]
- Abikoye, G.E. &Fusigboye, A. Gender, Locus of Control and Undergraduate Students’ Smoking Habit: Afr. J. Drug Alc Std.2010; 9(2):71-80.
- Adeyeye, O.O. Cigarette smoking habits among senior secondary school students in Lagos, South west Nigeria. Int J Biol Med Res.2011; 2(4): 1047 – 1050.
- Odey FA, Okokon IB, Jude Ogbeche Ogbeche, Godwin Terver Jombo, Emmanuel Eyo Ekanem Prevalence of cigarette smoking among adolescents in Calabar city, South-eastern Nigeria. Journal of Medicine and Medical Sciences Vol. 3(4) pp. 237-242, April 2012
- OLoughlin, J.L., Dugas, E., OLoughlin, I., Karp, E.K.O. & Sylvestre, M. (2014). Incidence and Determinants of Cigarette Smoking Initiation in Young Adults. Journal of Adolescent Health; 54.pp26-32
- Rodgers A, Ezzati M, Vander Hoom S, Lopez AD, et al. Distribution of major health risk: findings from the Global Burden of Disease study. PLoS Med. Oct 2004; 1(1):e27.
- Ayankogbe OO, Inem VA, Bamigbala OA, Roberts OA. Attitudes and determinants of cigarette smoking among rural dwellers in Southwest Nigeria. Nigerian Medical Practitioner 2003; 44: 70-74
- Ebirim IC Chikere, Morakinyo O Mayowa Prevalence and perceived health effect of alcohol use among male undergraduate students in Owerri, South-East Nigeria: a descriptive cross-sectional study BMC Public Health 2011, 11:118http://www.biomedcentral.com/1471-2458
- World Health Organization Global status report on alcohol and Health (2014). Genava, Switzerland. Accessed on 10th March 2017.
- S. Department of Health and Human Services. The Surgeon General’s Vision for a Health and Fit Nation 2010. Rockville, MD: U.S. Department of Health and Human Services, Office of the Surgeon General; January 2010
- Gersh BJ, Sliwa K, Mayosi BM, Yusuf S. Novel therapeutic concepts, The epidemic of cardiovascular disease in the developing world: global implications. European Heart Journal. 2010 March 1, 2010;31(6):642-8.
- Van de Vijver S, Akinyi H, Oti S, Olajide A, Agyemang C, Aboderin I, Kyobutungi C. Status report on hypertension in Africa- Consultative review for the 6th session of the African Union Conference of Ministers of Health on non-communicable diseases. Pan Afri Med J. 2013; 16:38-DOI: 10.11604/panj.2013. 16.38.3100.
- Peters DH, Garg A, Bloom G, Walker DG, Brieger WR, Rahman MH (2008). Poverty and access to healthcare in developing countries. NY Acad. Sci. 1136:161-171.
- Adedini O,Caldwell JC. The impact of public health services on mortality: a study of mortality differentials in a rural area of Nigeria. Popul Stud 1975; 29: 259_72
- Say L, Raine R. A systematic review of inequalities in the use of maternal health care in developing countries: examining the scale of the problem and the importance of context. Bull World Health Organ 2007; 85: 812_19.
- Nigeria National Health Conference 2009 Communique. Abuja, Nigeria. [Last accessed on 2010 Nov 5]. Available from: http://www.ngnhc.org
- Global Youth Tobacco Survey Collaborating Group (2003). Differences in worldwide tobacco use by gender: findings from the Global Youth Tobacco Survey. J. Sch. Health. 73: 207-15.
- Adekeye, Olujide A.1, Adeusi, Sussan O., Chenube, Olufunke O. Ahmadu, Frederick O. and Sholarin, Muyiwa A.1 Assessment of Alcohol and Substance Use among Undergraduates in Selected Private Universities in Southwest Nigeria IOSR Journal of Humanities and Social Science (IOSR-JHSS) Volume 20, Issue 3, Ver. II (Mar. 2015), PP 01-07
- Akpan,G and Ikorok M. The Prevalence of Alcohol Consumption among Commercial Drivers in Uyo Local Government Area, Akwa Ibom State Nigeria. IOSR Journal of Sports and Physical Education (IOSR-JSPE) e-ISSN: 2347-6737, p-ISSN: 2347-6745, Volume 1, Issue 7 (Nov - Dec. 2014), PP 47-51
- Ordinioha B, Brisibe S. Alcohol consumption among pregnant women attending the ante‑natal clinic of a tertiary hospital in South‑South Nigeria. Nigerian Journal of Clinical Practice Jan-Feb 2015 • Vol 18 • Issue 1
- Meursing, K. and Morojele, N. (1989), Use of Alcohol among High School Students in Lesotho. British Journal of Addiction, Volume 84, Issue 11, pages 1337–1342, November 1989
- JoAnn E. Manson, M.D., Dr.P.H., Heather Tosteson, Ph.D., Paul M. Ridker, M.D., Suzanne Satterfield, M.D., Dr. P.H., Patricia Hebert, Ph.D., Gerald T. O'Connor, D.Sc., Julie E. Buring, Sc.D., and Charles H. Hennekens, M.D., Dr. P.H.N Eng. The Primary Prevention of Myocardial Infarction. J Med 1992; 326:1406-1416May 21, 1992
- Alcohol and Public Policy Group. Alcohol: no ordinary commodity – a summary of the second edition. Addiction. 2010;105:769–779.
- Ezenkwa C. E., Akanji A. O., Akanje B. O., Unwin N. C., Adejuwon C. A. The Prevalence of Insulin Resistance and Other Cardiovascular Disease Risk Factors in Healthy Elderly Southwestern Nigerians. Atherosclerosis. 1997;128(2):201–11.
- Sobngwi E., Mbanya J. C. N., Unwin N. C., Kengne A. P., Fezeu L., Minkoulou E. M., Aspray T. J., Alberti K. G. Physical Activity and Its Relationship with Obesity, Hypertension and Diabetes in Urban and Rural Cameroon. International Journal of Obesity and Related Metabolic Disorders. 2002;26(7):1009–16.
- Forrest K. Y., Bunker C. H., Kriska A. M., Ukoli F. A., Huston S. L., Markovic N. Physical Activity and Cardiovascular Risk Factors in a Developing Population. Medicine and Science in Sports and Exercise. 2001;33(9):1598–160
- Adedini SA, Odimegwu C, Olusina B, Opeyemi F & Nicole D (2014) Barriers to accessing health care in Nigeria: Implications for child survival, Global Health Action, 7:1, 23499, DOI: 10.3402/gha.v7.23499
Corresponding Author
Ekpenyong NO
Department of Community Medicine, University of Calabar, Calabar, Nigeria
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.128
