Luke Allen|Julianne Williams|Nick Townsend|Bente Mikkelsen|Nia Roberts|Charlie Foster|Kremlin Wickramasinghe
Socioeconomic status and non-communicable disease behavioural risk factors in low-income and lower-middle-income countries: a systematic review
British Heart Foundation|University of Oxford|British Heart Foundation|University of Oxford|British Heart Foundation|University of Oxford|World Health Organization|University of Oxford|British Heart Foundation|University of Oxford|British Heart Foundation|University of Oxford
noncommunicable diseases leading global cause death disproportionately afflict living lowincome lowermiddleincome countries llmics association socioeconomic status noncommunicable disease behavioural risk factors well established highincome countries clear behavioural risk factors distributed within llmics aimed systematically review evidence association socioeconomic status harmful use alcohol tobacco use unhealthy diets physical inactivity within llmicswe searched 13 electronic databases including embase medline grey literature reference lists primary research published jan 1 1990 june 30 2015 included studies llmics presenting data multiple measures socioeconomic status tobacco use alcohol use diet physical activity age language restrictions applied excluded studies allow comparison less advantaged groups used piloted version cochrane effective practice organisation care group data collection checklist extract relevant data household individual level included full text studies including study type methods outcomes results due high heterogeneity used narrative approach data synthesis used descriptive statistics assess whether prevalence risk factor varied significantly members different socioeconomic groups study protocol registered prospero number crd42015026604after reviewing 4242 records 75 studies met inclusion criteria representing 2 135 314 individuals older 10 years 39 llmics low socioeconomic groups found significantly higher prevalence tobacco alcohol use high socioeconomic groups groups also consumed less fruit vegetables fish fibre high socioeconomic status high socioeconomic groups found less physically active consume fats salt processed food individuals low socioeconomic status included studies presented clear patterns tobacco use physical activity heterogeneity dietary outcome measures paucity evidence around harmful alcohol use limit certainty findingsdespite significant heterogeneity exposure outcome measures clear evidence shows burden behavioural risk factors affected socioeconomic position within llmics governments seeking meet sustainable development goal sdg 34reducing premature noncommunicable disease mortality third 2030should leverage development budgets address povertyhealth nexus settings findings also significance health workers serving populations policy makers tasked preventing controlling rise noncommunicable diseaseswho