Background
Urbanization and non-communicable disease
Use of quantitative tools to measure urbanicity as an exposure for NCD
Methods
Selection and description of participants
Variables
Scale Construction: Variable Selection
Variables Included
Population Size
Economic Activity
Built Environment
Communication
Education
Diversity
Health Services
Dimension | Indicator name | Overall | Ethiopia | India | Peru |
---|---|---|---|---|---|
N/A
|
Number of communities
| 59 (100%) | 20 (34%) | 19 (32%) | 20 (34%) |
Population Size
|
Population size
| ||||
Mean (Median)
| 8538 (3855) | 11645 (8521) | 2746 (1764) | 10933 (2005) | |
Range
| 388 - 61740 | 2835 - 40101 | 832- 11433 | 388- 61740 | |
Economic Activity
|
% of community in agriculture
| ||||
Mean (Median)
| 45 (54) | 44 (51) | 47 (56) | 42 (55) | |
Range
| 0-89 | 0-89 | 2-75 | 0-89 | |
Built Environment
|
Paved road (number of communities)
| 27 (45.8%) | 12 (20.3%) | 3 (5.1%) | 12 (20.3%) |
Unpaved road for motor traffic
| 40 (67.8%) | 13 (65.0%) | 19 (100%) | 8 (40.0%) | |
Non-motorized road
| 15 (25.4%) | 10 (50.0%) | 4 (2.1%) | 1 (5.0%) | |
Sewage service
| 28 (47.5%) | 6 (30.0%) | 11 (57.9%) | 11 (55.0%) | |
Electricity service
| 46 (78.0%) | 10 (50.0%) | 19 (100.0%) | 17 (85.0%) | |
% community with electricity
| |||||
Mean (Median)
| 69 (83) | 43 (34) | 90 (91) | 76 (83) | |
Range
| 0-100 | 0-100 | 70-100 | 17-100 | |
% community with flush toilet
| |||||
Mean (Median)
| 22 (7) | 1 (0) | 17 (8) | 49 (56) | |
Range
| 0-94 | 0-5 | 0-89 | 2-94 | |
Communication
|
Theatre (number of communities)
| 7 (11.89%) | 6 (30.00%) | 1 (5.26%) | 0 (0.00%) |
Public internet
| 15 (25.42%) | 3 (15.00%) | 2 (10.50%) | 10 (50.00%) | |
Public telephone
| 47 (79.66%) | 14 (70.00%) | 16 (84.20%) | 17 (85.00%) | |
% community owns mobile phone
| |||||
Mean (Median)
| 21 (12) | 9 (2) | 22 (17) | 33 (32) | |
Range
| 0-72 | 0-42 | 4-60 | 1-72 | |
% community owns TV
| |||||
Mean (Median)
| 43 (37) | 14 (2) | 44 (35) | 70 (82) | |
Range
| 0-99 | 0-64 | 22-86 | 26-99 | |
Education
|
Nursery or preschool (number of communities)
| 23 (39.0%) | 8 (40.0%) | 4 (21.1%) | 11 (55.0%) |
Primary school
| 58 (98.3%) | 19 (95.0%) | 19 (100.0%) | 20 (100.0%) | |
Secondary school
| 22 (37.3%) | 5 (25.0%) | 9 (47.3%) | 8 (40.0%) | |
University
| 2 (3.4%) | 1 (5.0%) | 0 (0.0%) | 1 (5.0%) | |
Average yrs of mother’s ed.
| |||||
Mean (Median)
| 4.8 (3.7) | 2.9 (2.0) | 3.6 (2.7) | 7.8 (8.4) | |
Range
| 0.1-11.2 | 0.1-7.7 | 0.7-8.7 | 1.6-11.2 | |
Diversity
|
Variance in housing quality index*
| ||||
Mean (Median)
| 0.18 (0.18) | 0.10 (0.10) | 0.23 (0.23) | 0.21 (0.22) | |
Range
| 0.02-0.34 | 0.02-0.20 | 0.14-0.34 | 0.11-0.33 | |
Variance in mother’s ed.*
| |||||
Mean (Median)
| 3.34 (3.48) | 2.69 (2.55) | 3.69 (3.80) | 3.64 (3.55) | |
Range
| 0.44-5.10 | 0.44-5.10 | 2.01-4.90 | 2.50-4.55 | |
Health
|
Hospital (number of communities)
| 8 (13.6%) | 1 (5.0%) | 4 (21.1%) | 3 (15.0%) |
Health centre
| 14 (23.7%) | 5 (25.0%) | 5(26.3%) | 4 (20.0%) | |
Dispensary
| 29 (49.2%) | 8 (40.0%) | 7 (36.8%) | 14 (70.0%) | |
Midwife
| 25 (42.4%) | 8 (40.0%) | 6 (31.6%) | 11 (55.0%) | |
Village health worker
| 38 (64.4%) | 12 (60.0%) | 7 (36.8%) | 19 (95.0%) |
Additional Variables
Scale Scoring
Component | Scale scoring | |
---|---|---|
Demographic
| ||
Variables used:
| ||
Approximately how many people (including children) live in this locality? | 1–500 | 1 point |
501–1000 | 2 points | |
1001–2000 | 3 points | |
2001–4000 | 4 points | |
4001–6000 | 5 points | |
6001–8000 | 6 points | |
8001–10,000 | 7 points | |
10,001–15,000 | 8 points | |
15001--20000 | 9 points | |
>20000 | 10 points | |
Economic Activity
| ||
Variable used:
| ||
Proportion of population involved in agriculture (primary occupation) | 10 points- 10*(proportion of population involved in agriculture) | |
Built Environment
| ||
Variables used:
| ||
Types of road in locality | Paved road | 2 points |
Unpaved road for motor traffic | 1 point | |
Non-motorized Roads | 0 points | |
Sewage services | Sewage services | 2 points |
Proportion of households with flush toilet | 2 points* proportion | |
Electricity service | Electricity in community | 2 points |
Proportion of households with electricity | 2 points *proportion | |
Communication
| ||
Variables used:
| ||
Proportion of houses with television, mobile phone | Proportion of households with television | 2 points *proportion |
Proportion of households with mobile phone | 2 points *proportion | |
Communication services in locality | Movie theatre | 2 points |
Public internet | 2 points | |
Public telephone | 2 points | |
Education
| ||
Variables used:
| ||
Educational facilities in locality | Nursery and/or preschool | 2 points |
Primary School | 2 points | |
Secondary School | 2 points | |
University | 2 points | |
Average education of mothers in community (years) | Average education/6 | |
Diversity
| ||
Variables used:
| ||
Variance in housing quality index | Decile 10 | 5 points |
Decile 9 | 4.5 points | |
Decile 8 | 4 points | |
Decile 7 | 3.5 points | |
Decile 6 | 3 points | |
Decile 5 | 2.5 points | |
Decile 4 | 2 points | |
Decile 3 | 1.5 points | |
Decile 2 | 1 points | |
Decile 1 | 0.5 points | |
Variance in mother’s education | Decile 10 | 5 points |
Decile 9 | 4.5 points | |
Decile 8 | 4 points | |
Decile 7 | 3.5 points | |
Decile 6 | 3 points | |
Decile 5 | 2.5 points | |
Decile 4 | 2 points | |
Decile 3 | 1.5 points | |
Decile 2 | 1 points | |
Decile 1 | 0.5 points | |
Health
| ||
Variables used:
| ||
Health facilities available | Hospital (public or private) | 2 points |
Health Center (public or private) | 2 points | |
Dispensary/Pharmacy | 2 points | |
Health workers available | Midwife | 2 points |
Village Health Worker | 2 points |
Scale Properties, Reliability and Validity
Results
Scale description
Overall | Ethiopia | India | Peru | |
---|---|---|---|---|
Domain
|
Mean (St. Dev.)
|
Mean (St. Dev.)
|
Mean (St. Dev.)
|
Mean (St. Dev.)
|
Population Size
| 5.2 (2.7) | 6.9 (1.8) | 3.7 (1.4) | 5.0 (3.5) |
Economic Activity
| 5.5 (3.2) | 5.5 (3.7) | 5.3 (2.5) | 5.8 (3.5) |
Built Environment
| 5.8 (2.7) | 4.0 (2.7) | 6.5 (1.3) | 6.8 (2.9) |
Communications
| 3.6 (2.3) | 2.8 (2.2) | 3.3 (1.9) | 4.8 (2.4) |
Education
| 4.4 (2.2) | 3.8(2.3) | 4.0 (2.0) | 5.3 (2.1) |
Diversity
| 5.5 (2.4) | 3.4 (2.1) | 6.8 (1.7) | 6.4 (1.6) |
Health
| 4.5 (2.5) | 4.4 (2.6) | 3.7 (1.9) | 5.4 (2.8) |
Scale Total
|
34.5 (13.9)
|
30.7 (14.5)
|
33.2 (9.2)
|
39.4 (16.0)
|
Scale validation results
Domain | Corrected item-scale correlation |
---|---|
Population Size | 0.50 |
Economic Activity | 0.88 |
Built Environment | 0.73 |
Communication | 0.80 |
Education | 0.85 |
Diversity | 0.40 |
Health | 0.62 |
Construct Validity
Ethiopia | India | Peru | |
---|---|---|---|
Urbanicity of site | Urbanicity of site | Urbanicity of site | |
Average housing quality index of site
|
110.1
|
28.3
|
98.4
|
(p) | (0.000) | (0.025) | (0.000) |
Observations | 20 | 19 | 20 |
R-squared | 0.51 | 0.26 | 0.76 |
Adjusted R-squared | 0.49 | 0.22 | 0.75 |
Average consumer durables index of site
|
175.0
|
105.1
|
91.7
|
(p) | (0.000) | (0.000) | (0.000) |
Observations | 20 | 19 | 20 |
R-squared | 0.68 | 0.79 | 0.87 |
Adjusted R-squared | 0.66 | 0.78 | 0.86 |