The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia

Abstract Introduction Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment. Methodology...

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Main Authors: Aaron Kobina Christian, Egerson Daniel, Olutobi Adekunle Sanuade
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23769-y
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author Aaron Kobina Christian
Egerson Daniel
Olutobi Adekunle Sanuade
author_facet Aaron Kobina Christian
Egerson Daniel
Olutobi Adekunle Sanuade
author_sort Aaron Kobina Christian
collection DOAJ
description Abstract Introduction Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment. Methodology Using data from the 2017 Zambia WHO STEPS survey (N = 4,302 adults, mean age: 36.57 years), Latent Class Analysis identified NCD risk profiles, and multinomial logistic regression assessed their associations with socioeconomic determinants. Results Three NCD risk groups emerged: Low-Risk (12.0%), Intermediate-Risk (64.3%), and High-Risk (23.7%). The Low-Risk group maintained healthy lifestyles. The Intermediate-Risk group, the most prevalent, showed borderline metabolic indicators and occasional unhealthy behaviours. The High-Risk group exhibited multiple risk factors, including obesity, hypertension, diabetes, and substance use. Males had 22.8 times higher odds of being in the High-Risk group than females. Surprisingly, higher education increased the odds of being in the Moderate- and High-Risk groups. Conclusion NCD prevention in Zambia requires risk-stratified strategies: primary prevention for Intermediate-Risk groups and intensive intervention for High-Risk populations. Critical policy actions include taxing tobacco, alcohol, and unhealthy foods; expanding universal screening; integrating NCD care into primary health systems; and addressing urbanization, cultural practices, and healthcare disparities.
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spelling doaj-art-46552bc52cfa4e2caa3db52b1bef05b02025-08-20T04:02:42ZengBMCBMC Public Health1471-24582025-07-0125111110.1186/s12889-025-23769-yThe silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in ZambiaAaron Kobina Christian0Egerson Daniel1Olutobi Adekunle Sanuade2Regional Institute for Population Studies, University of GhanaRegional Institute for Population Studies, University of GhanaDepartment of Population Health Sciences, Division of Health System Innovation and Research Spencer Fox Eccles School of Medicine University of UtahAbstract Introduction Non-communicable diseases (NCDs) are a public health challenge in Zambia. This is driven by economic transitions, urbanization, and lifestyle changes. This study examines how NCDs cluster and relate to socioeconomic factors such as education, income, and employment. Methodology Using data from the 2017 Zambia WHO STEPS survey (N = 4,302 adults, mean age: 36.57 years), Latent Class Analysis identified NCD risk profiles, and multinomial logistic regression assessed their associations with socioeconomic determinants. Results Three NCD risk groups emerged: Low-Risk (12.0%), Intermediate-Risk (64.3%), and High-Risk (23.7%). The Low-Risk group maintained healthy lifestyles. The Intermediate-Risk group, the most prevalent, showed borderline metabolic indicators and occasional unhealthy behaviours. The High-Risk group exhibited multiple risk factors, including obesity, hypertension, diabetes, and substance use. Males had 22.8 times higher odds of being in the High-Risk group than females. Surprisingly, higher education increased the odds of being in the Moderate- and High-Risk groups. Conclusion NCD prevention in Zambia requires risk-stratified strategies: primary prevention for Intermediate-Risk groups and intensive intervention for High-Risk populations. Critical policy actions include taxing tobacco, alcohol, and unhealthy foods; expanding universal screening; integrating NCD care into primary health systems; and addressing urbanization, cultural practices, and healthcare disparities.https://doi.org/10.1186/s12889-025-23769-yNCDsSocioeconomic determinants of healthLatent class analysis (LCA)Zambia
spellingShingle Aaron Kobina Christian
Egerson Daniel
Olutobi Adekunle Sanuade
The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia
BMC Public Health
NCDs
Socioeconomic determinants of health
Latent class analysis (LCA)
Zambia
title The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia
title_full The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia
title_fullStr The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia
title_full_unstemmed The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia
title_short The silent epidemic: unravelling NCD risk clusters and socioeconomic determinants in Zambia
title_sort silent epidemic unravelling ncd risk clusters and socioeconomic determinants in zambia
topic NCDs
Socioeconomic determinants of health
Latent class analysis (LCA)
Zambia
url https://doi.org/10.1186/s12889-025-23769-y
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