Document Type : Original Article

Authors

Abstract

BACKGROUND: Noncommunicable diseases (NCDs) are the leading causes of mortality worldwide.
Environmental factors play an important role in development of risk factors. Hence, the study was
done to assess the neighborhood environmental factors related to NCDs in urban area.
METHODOLOGY: This community‑based cross‑sectional study was carried out among three selected
wards of urban Puducherry. All shops/establishments related to the risk of NCDs within the study
area were study units. Information regarding tobacco, alcohol, diet, and physical activity‑related
establishments was assessed using pretested semi‑structured pro forma. Shops/establishments were
labeled either as “favorable” (prevents the risk of NCDs) or “unfavorable” (increases the risk of NCDs).
RESULTS: Among 655 establishments, 372 (56.8%) belonged to favorable and 283 (43.2%)
to unfavorable category, respectively. Tobacco‑related establishments amount to 15.1% (95%
confidence interval: 12.6–18.1) of the total establishments. Among these tobacco establishments,
almost one‑third were selling tobacco to minor and located within 100 m of school. Fruits and vegetable
markets contributed to 21.8% of the total establishments. About 22% of the establishments were
fast‑food outlets. Public health sports facilities were only 6.8% of the total establishments.
CONCLUSION: The current study reported almost equal distribution of favorable and unfavorable
establishments. However, among unfavorable establishments, tobacco establishments raised
concern as one‑third of those were selling tobacco to minors. Healthy diet and physical activity related
establishments were also found to be less. Hence, corrective measures are to be implemented which
will reduce the burden of behavioral risk factors.

Keywords

1. World Health Organization. Deaths from Cardiovascular Diseases
and Diabetes. World Health Organization. Available from: http://
www.who.int/gho/ncd/mortality_morbidity/cvd/en/. [Last
accessed on 2018 Feb 28].
2. Ghaffar A, Reddy KS, Singhi M. Burden of non‑communicable
diseases in South Asia. BMJ 2004;328:807‑10.
3. World Health Organization. Cardiovascular Diseases (CVDs).
World Health Organization. Available from: http://www.
who.int/mediacentre/factsheets/fs317/en/. [Last accessed on
2018 Feb 28].
4. World Health Organization. NCD Country Profiles. World Health
Organization; 2011. Available from: http://www.who.int/nmh/
countries/ind_en.pdf?ua=1. [Last accessed on 2018 Feb 28].
5. Phaswana‑Mafuya N, Peltzer K, ChirindaW, MusekiwaA, KoseZ.
Sociodemographic predictors of multiple non‑communicable
disease risk factors among older adults in South Africa. Glob Health Action 2013;6:20680.
6. Bhagyalaxmi A, Atul T, Shikha J. Prevalence of risk factors of
noncommunicable diseases in a district of Gujarat, India. J Health
Popul Nutr 2013;31:78‑85.
7. Hill JO, Peters JC. Environmental contributions to the obesity
epidemic. Science 1998;280:1371‑4.
8. Prince SA, Kristjansson EA, Russell K, Billette JM, Sawada M,
Ali A, et al. A multilevel analysis of neighbourhood built and social
environments and adult self‑reported physical activity and body
mass index in Ottawa, Canada. Int J Environ Res Public Health
2011;8:3953‑78.
9. JaimePC, DuranAC, SartiFM, LockK. Investigating environmental
determinants of diet, physical activity, and overweight among
adults in Sao Paulo, Brazil. J Urban Health 2011;88:567‑81.
10. Wall MM, Larson NI, Forsyth A, Van Riper DC, Graham DJ,
Story MT, et al. Patterns of obesogenic neighborhood features
and adolescent weight: A comparison of statistical approaches.
Am J Prev Med 2012;42:e65‑75.
11. National Nutrition Monitoring Bureau. Diet and nutritional
status of rural population. NNMB Technical Report No. 21.
Hyderabad: National Institute of Nutrition, Indian Council of
Medical Research; 2012.
12. International Institute for Population Sciences. National Family
Health Survey‑4, India Fact Sheet. India, 2015‑16. Mumbai: IIPS;
2016. Available from: http://www.rchiips.org/NFHS/pdf/
NFHS4/India.pdf. [Last accessed on 2018 Feb 28].
13. Preventing Noncommunicable Diseases (NCDs) by Reducing
Environmental Risk Factors. (WHO/FWC/EPE/17.1). Licence:
CC BY‑NC‑SA 3.0 IGO. Geneva: World Health Organization; 2017.
14. Norman RE, Carpenter DO, Scott J, Brune MN, Sly PD.
Environmental exposures: An underrecognized contribution to
noncommunicable diseases. Rev Environ Health 2013;28:59‑65.
15. Eriksson U, Arvidsson D, Sundquist K. Availability of exercise
facilities and physical activity in 2,037 adults: Cross‑sectional
results from the Swedish neighborhood and physical
activity (SNAP) study. BMC Public Health 2012;12:607.
16. Lee SA, Ju YJ, Lee JE, Hyun IS, Nam JY, Han KT, et al. The
relationship between sports facility accessibility and physical
activity among Korean adults. BMC Public Health 2016;16:893.
17. OpenEpi – Toolkit Shell for Developing New Applications.
Available from: http://www.openepi.com/SampleSize/
SSPropor.htm. [Last accessed on 2017 Oct 31].
18. Priyanka R, Rao A, Rajesh G, Ramya S, Mithun PB. Compliance
with statutory tobacco guidelines in and around schools in
Mangaluru, India: An observational study. World J Dent
2017;8:10‑3.
19. Goel S, Sardana M, Jain N, Bakshi D. Descriptive evaluation of
cigarettes and other tobacco products act in a North Indian city.
Indian J Public Health 2016;60:273‑9.
20. Jain ML, Chauhan M, SinghR. Compliance assessment of cigarette
and other tobacco products act in public places of Alwar district
of Rajasthan. Indian J Public Health 2016;60:107‑11.
21. Aaron KJ, Sanders PW. Role of dietary salt and potassium intake
in cardiovascular health and disease: A review of the evidence.
Mayo Clin Proc 2013;88:987‑95.
22. Dendup T, Feng X, Clingan S, Astell‑Burt T. Environmental risk
factors for developing type 2 diabetes mellitus: A systematic
review. Int J Environ Res Public Health 2018;15. pii: E78.