A systematic review study conducted by Luke Allen et al., have found that socioeconomic status contributes significantly to the prevalence of non-communicable diseases, especially in the behavioural risk factors in low-income and lower-middle-income countries. Their interpretation suggested that the burden of behavioural risk factors is affected by socioeconomic position within these countries. Therefore, governments seeking to meet Sustainable Development Goals (SDG) 3.4 in order to reduce the premature death of non communicable diseases by a third in 2030 should focus on their development budgets to address the poverty-health conditions in these settings.
One key observation was that low socioeconomic groups in most LLMICs were more likely to engage in tobacco and alcohol use while consuming fewer fruits, vegetables, fish, and fiber, and more meat. These trends mirrored well-established patterns observed in high-income countries. The study also underscored the urgent need for quantifying the burden of risky alcohol use in LLMICs, as data in this regard were lacking, especially in Africa.
Dietary habits exhibited variations by socioeconomic status. High-income settings typically show a positive association between socioeconomic status and the consumption of healthy foods like fruits, vegetables, fiber, and fish. However, in LLMICs, the opposite trend was observed, with lower socioeconomic groups consuming more salt and processed foods. The lack of studies on salt intake was noted as a gap in understanding the impact of this dietary risk factor.
Physical activity patterns differed between rural and urban settings within LLMICs. Rural high socioeconomic status groups tended to be more physically inactive, contrary to high-income countries where urban populations often exhibited lower physical activity levels. This divergence may be attributed to the physically demanding occupations of rural low socioeconomic status groups.
In terms of strategies, it was emphasized that NCD prevention efforts must be context-specific. Policymakers and development agencies should review the evidence relevant to their settings and tailor interventions accordingly. Education emerged as a powerful tool in controlling NCDs, particularly in urban areas where leisure-time physical activity played a crucial role. However, the inconsistent definitions and measurement methods for behavioral risk factors highlighted the need for standardized surveillance and reporting to better inform strategies targeting NCDs in these regions.
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