A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana

Abstract Background Overweight and obesity are more prevalent among urban than rural populations in Africa, yet evidence on these disparities specifically among men remains limited. This study examined the urban-rural disparities and associated factors in overweight/obesity among Ghanaian men aged 2...

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Main Authors: Prince Tsekpetse, Samuel Salu, Joshua Shiuma, Brenda Nambozo, Brian Tonny Makoko, Bright Opoku Ahinkorah
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-23238-6
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author Prince Tsekpetse
Samuel Salu
Joshua Shiuma
Brenda Nambozo
Brian Tonny Makoko
Bright Opoku Ahinkorah
author_facet Prince Tsekpetse
Samuel Salu
Joshua Shiuma
Brenda Nambozo
Brian Tonny Makoko
Bright Opoku Ahinkorah
author_sort Prince Tsekpetse
collection DOAJ
description Abstract Background Overweight and obesity are more prevalent among urban than rural populations in Africa, yet evidence on these disparities specifically among men remains limited. This study examined the urban-rural disparities and associated factors in overweight/obesity among Ghanaian men aged 20–49. Methods We analysed data from the 2022 Ghana Demographic and Health Survey, with a total sample of 4,797 men aged 20–49 with valid BMI measurements. Overweight/obesity was defined as a BMI ≥ 25 kg/m². Data were analysed using Stata version 17.0. A multivariate nonlinear decomposition model assessed the contributions of sociodemographic characteristics to urban–rural disparities in overweight/obesity. Results The prevalence of overweight/obesity was significantly higher among urban men (27.48%) than rural men (12.03%). Differences in sociodemographic characteristics explained 87% of the observed urban–rural disparities, with differences in wealth index explaining over half (77%) of the urban-rural differences in overweight/obesity. Factors associated with overweight/obesity included age, wealth index, marital status, and alcohol use, while smoking was protective. Among urban men, the odds of overweight/obesity were higher in those aged 30–34 years (AOR = 2.56; 95% CI: 1.37–4.79), 35–39 years (AOR = 2.86; 95% CI: 1.54–5.30), 40–44 years (AOR = 2.80; 95% CI: 1.56–5.03), and 45–49 years (AOR = 4.47; 95% CI: 2.20–9.07). Wealth was a strong predictor across settings; urban men in the richest quintile had an AOR of 17.37 (95% CI: 5.41–55.83), compared to 5.35 (95% CI: 2.76–10.34) among rural men. Alcohol use was significantly associated with overweight/obesity among urban men (AOR = 1.49; 95% CI: 1.09–2.04), while smoking showed a protective association in rural men (AOR = 0.33; 95% CI: 0.13–0.86). Conclusion This study shows that urban–rural disparities in overweight/obesity among men are largely driven by differences in wealth index. Socioeconomic differences should be considered when designing interventions to reduce overweight and obesity among men. Targeted strategies promoting healthy eating and physical activity, particularly among men in urban settings, are essential to address these disparities.
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spelling doaj-art-16aebe1f53674bb6afa8dfb13021c6ea2025-08-20T03:16:56ZengBMCBMC Public Health1471-24582025-05-0125111110.1186/s12889-025-23238-6A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in GhanaPrince Tsekpetse0Samuel Salu1Joshua Shiuma2Brenda Nambozo3Brian Tonny Makoko4Bright Opoku Ahinkorah5Department of Community and Public Health, Busitema UniversityDepartment of Epidemiology and Biostatistics, Fred. N. Binka School of Public Health, University of Health and AlliedDepartment of Community and Public Health, Busitema UniversityDepartment of Community and Public Health, Busitema UniversityDepartment of Community and Public Health, Busitema UniversityFaculty of Health and Medical Sciences, The University of AdelaideAbstract Background Overweight and obesity are more prevalent among urban than rural populations in Africa, yet evidence on these disparities specifically among men remains limited. This study examined the urban-rural disparities and associated factors in overweight/obesity among Ghanaian men aged 20–49. Methods We analysed data from the 2022 Ghana Demographic and Health Survey, with a total sample of 4,797 men aged 20–49 with valid BMI measurements. Overweight/obesity was defined as a BMI ≥ 25 kg/m². Data were analysed using Stata version 17.0. A multivariate nonlinear decomposition model assessed the contributions of sociodemographic characteristics to urban–rural disparities in overweight/obesity. Results The prevalence of overweight/obesity was significantly higher among urban men (27.48%) than rural men (12.03%). Differences in sociodemographic characteristics explained 87% of the observed urban–rural disparities, with differences in wealth index explaining over half (77%) of the urban-rural differences in overweight/obesity. Factors associated with overweight/obesity included age, wealth index, marital status, and alcohol use, while smoking was protective. Among urban men, the odds of overweight/obesity were higher in those aged 30–34 years (AOR = 2.56; 95% CI: 1.37–4.79), 35–39 years (AOR = 2.86; 95% CI: 1.54–5.30), 40–44 years (AOR = 2.80; 95% CI: 1.56–5.03), and 45–49 years (AOR = 4.47; 95% CI: 2.20–9.07). Wealth was a strong predictor across settings; urban men in the richest quintile had an AOR of 17.37 (95% CI: 5.41–55.83), compared to 5.35 (95% CI: 2.76–10.34) among rural men. Alcohol use was significantly associated with overweight/obesity among urban men (AOR = 1.49; 95% CI: 1.09–2.04), while smoking showed a protective association in rural men (AOR = 0.33; 95% CI: 0.13–0.86). Conclusion This study shows that urban–rural disparities in overweight/obesity among men are largely driven by differences in wealth index. Socioeconomic differences should be considered when designing interventions to reduce overweight and obesity among men. Targeted strategies promoting healthy eating and physical activity, particularly among men in urban settings, are essential to address these disparities.https://doi.org/10.1186/s12889-025-23238-6Obesity/overweightBody mass indexUrban-ruralGhanaDemographic and health survey
spellingShingle Prince Tsekpetse
Samuel Salu
Joshua Shiuma
Brenda Nambozo
Brian Tonny Makoko
Bright Opoku Ahinkorah
A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana
BMC Public Health
Obesity/overweight
Body mass index
Urban-rural
Ghana
Demographic and health survey
title A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana
title_full A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana
title_fullStr A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana
title_full_unstemmed A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana
title_short A multivariate non-linear decomposition analysis of urban-rural disparities in overweight/obesity among men aged 20–49 in Ghana
title_sort multivariate non linear decomposition analysis of urban rural disparities in overweight obesity among men aged 20 49 in ghana
topic Obesity/overweight
Body mass index
Urban-rural
Ghana
Demographic and health survey
url https://doi.org/10.1186/s12889-025-23238-6
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