The impact of residential and non-residential environments on non-communicable disease in Ghanaian cities: The role of gender

Uncertainties around exposures in non-residential contexts complicate the understanding of neighborhood environments and health outcomes in low-and middle-income countries (LMICs) partly due to limited research on where people spend their day and how those spaces impact their health. The goal of this study, therefore, was to examine the relationship between time spent in/outside residential neighborhoods, length of stay in neighborhood and non-communicable diseases (NCDs) status and whether the relationship differs by gender. We used cross-sectional data from three Ghanaian cities and applied multilevel analysis. At the general level, we did not observe any significant difference between where people spend their day and NCDs status. After aggregating the data by gender, however, we found that men who spent some time outside their residential neighborhood in a typical week were about 2 times likely to be diagnosed with NCDs compared to those who spend the entire week in their residential neighborhoods. This relationship, however, was not statistically significant for women. On the other hand, longer stay in current neighborhood was associated with women's likelihood of being diagnosed with NCDs. These findings contribute to a nuanced understanding of neighborhood environments and NCD outcomes and offer directions for public health and environmental policy.