Prince Michael Amegbor
Prince Michael Amegbor
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Assistant Professor of Global and Environmental Health
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Professional overview
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As a health geographer using big data and a multi-methods approach in his research on the environmental and social determinants of health, Dr. Prince Michael Amegbor is an assistant professor in the Department of Global and Environmental Health. He specializes in visualizing the geospatial distribution of risks and burdens on health that are associated with environmental exposures. He works to unravel how factors such as climate change, air pollution and other environmental exposures contribute to health inequalities, particularly in Sub-Saharan Africa and other geographic contexts (e.g., Denmark).
Prior to his appointment at GPH, Dr. Amegbor was a postdoctoral research fellow with the Big Data Centre for Environment and Health (BERTHA) and the Department of Environmental Science at Aarhus University (Denmark). He is also a guest researcher at Statistics Denmark and has worked as a co-task leader of two European Union Horizon 2020 Projects: REGREEN and ICARUS (Integrated Climate forcing and Air pollution Reduction in Urban Systems).
Dr. Amegbor has published dozens of articles in peer-reviewed scholarly journals including Scientific Report, Health & Place and Applied Geography. He earned his PhD in human geography from Queen’s University in Ontario, and holds an MPhil in development geography from the University of Oslo. He obtained his undergraduate degree in geography and resource development from the University of Ghana, Legon.
Below are links to the results from ICARUS – Favorite Location Study published in the Environment and Planning B: Urban Analytics and City Science journal:
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Education
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PhD, Department of Geography & Planning, Queen’s University, Kingston, OntarioMPhil Developmental Geography, University of Oslo, Oslo, NorwayBA Geography & Resource Development, University of Ghana, Accra
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Honors and awards
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Principal's International Doctoral Award, Queen’s University (201520162017)Quota Scheme Scholarship, Department of Sociology & Human Geography, University of Oslo (201220132014)
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Areas of research and study
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Aging and the Life CourseAlternative MedicineChild HealthComplementary MedicineEnvironmental Public Health ServicesImmigrant HealthPublic Health PolicySocial Determinants of HealthSocio-cultural Identities and Health Seeking BehaviorsTraditional MedicineUrban GeographyViolence and VictimisationWomen's Health
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Publications
Publications
Assessing the Effect of Pre- and Post-natal Environmental Exposures, Geographic Factors and Socio-Economic Conditions on Acute Respiratory Infections among Children Under Five in Sub-Saharan Africa – A Machine Learning Approach
AbstractWang, R., Siguenza, C., Dadwal-Gupta, E., North, H., Wu, R., Yang, X., Zhang, Z., & Amegbor, P. M. (n.d.).Publication year
2025Journal title
PLOS OneAbstract~Exploring the effect of early-life climate anomalies on child growth in Sub-Saharan African context : Insight from the demographic & health survey
AbstractAmegbor, P. M., Lapurga, K., Carr, E., Guerrero, M., Babayode, O., Crisci, S. E., Fang, X. Y., Siddeky, A., & Quansah, R. (n.d.).Publication year
2025Journal title
Science of the Total EnvironmentVolume
983AbstractBackground: Childhood malnutrition remains a critical public health issue in Sub-Saharan Africa (SSA), with about 30 % of children affected by stunting, a marker of chronic malnutrition and micronutrient deficiencies during early development. While previous research suggests a link between climatic conditions and child growth, a deeper understanding is needed, particularly across diverse climatic zones. This study explores the impact of prenatal and postnatal climate anomalies (temperature and precipitation) on stunted growth among children in SSA. Methods: We analyzed health and demographic data from 30 SSA countries (2004–2021) within a Big Data framework, incorporating climatic and environmental data. Using three Bayesian hierarchical models, we examined the linear associations between pre- and post-natal climate anomalies and stunted growth, focusing on deviations from reference period means. Findings: Approximately 34.5 % of children in the study were stunted. The analysis identified significant associations between maximum temperature anomalies and increased stunting, while mean temperature and precipitation anomalies had varying effects. Reduced maximum temperatures were linked to lower stunting rates, whereas increased temperatures consistently correlated with higher stunting probabilities. Additionally, children residing in the Tropical Monsoon (Am) zone had a lower likelihood of stunting, whereas certain temperate zones were associated with increased stunting. Interpretation: The study highlights a complex relationship between climate anomalies and child growth in SSA. It underscores the need for targeted, context-specific policies that integrate climate adaptation with child health initiatives to address the growing impacts of climate change on child health in the region.Exploring the Impact of Early-Life Climate Anomalies on Child Growth: A Developmental Origins of Health and Disease (DoHD) Perspective
AbstractAmegbor, P. M., Lapurga, K., Carr, E., Guerrero, M., Babayode, O., Sarah, C. E., Fang, X. Y., Siddeky, A., & Quansah, R. (n.d.).Publication year
2025Journal title
Science of the Total EnvironmentAbstract~Kitchen cooking burns : A real danger for adults and children in Ghana
AbstractCodjoe, A. B., Asare, L. S., Tettey, P., Ochieng, C., Amegbor, P. M., Boateng, G., Sackey, B., Addade, M., Norvivor, F. A., & Quansah, R. (n.d.).Publication year
2025Journal title
BurnsVolume
51Issue
4AbstractBackground: In many low- and middle-income countries (LMICs), stove and fuel stacking are frequent practices. However, the impact of stacking on health, particularly cooking-related burns (CRBs), is unknown. This study aims to examine the prevalence and severity of CRBs and to identify associated household factors. Emphasis was placed on cooking behaviors and practices (i.e., fuel choice and stacking) that influence CRBs. Methods: This study is a baseline for the Briquette for Cooking Fuel Project (B4CcokingF), a cluster randomized controlled trial in riparian communities in southern Ghana. The baseline data collection started in June 2019 and ended in October 2022. To start with, trained field workers, led by a community representative, visited eligible households (HHs) in each community and conducted interviews with a structured questionnaire. 420 primary cooks age between 25 and 68 years were interviewed on cooking behaviour and practices as well as cooking-related burns and injuries using a slightly modified, well-established, and validated World Health Organization (WHO)-harmonized questionnaire to monitor household energy use and Sustainable Development Goals (SDG) indicators 7.1.1 and 7.1.2. Results: CRBs were prevalent in 31.8 % of adult primary cooks. The majority of moderate and severe CRBs—roughly 61 % and 27 %, respectively—occurred in the kitchen by contact with a hot stove. Belonging to a middle wealth index status was protective against CRBs in adults but having more than 10 people in a HH was a significant risk factor of adult CRBs. A unit increase in the number of rooms in a HH was associated with a 43 % increase in the risk of CRBs in adults. Approximately 16 % of children suffer from CRBs, and 64 % sustain severe burns, with the majority of these incidents occurring in the kitchen at home. A HH having a family size of 6–10 was positively associated with CRBs, but using an LPG cookstove was protective in children. Mixed stacking defined as stacking LPG with polluting fuel (PR=2.10, 95 %, confidence interval (CI): 1.12, 3.94) was associated with CRBs in children but not adults. Conclusion: Factors associated with adult CRBs include middle wealth index status, the number of rooms in a household, and having more than 10 people in a household. Having a family size of 6–10 and the use of LPG by the HH were associated with child CRB risk. Mixed stacking is associated with CRBs in children, but the findings among adult cooks were inconclusive. The children population is disproportionately affected; therefore, it is essential to develop and execute customized preventative initiatives that cater to their specific vulnerabilities. The paramount objective of Ghana's initiatives to enhance access to liquefied petroleum gas should be the assurance of safe usage.Nature’s toll: The effect of climate anomalies and ambient air pollution on spontaneous miscarriage in Ghana. Journal: Communications Earth & Environment
AbstractAmegbor, P. M., Yankey, O., & Peprah, E. (n.d.).Publication year
2025Journal title
Nature Communications Earth & EnvironmentAbstract~Personal exposure to traffic-related air pollution among adult street traders in Lagos, Nigeria: A pilot study
AbstractOzoh, O., Amegbor, P. M., Adeyeye, O., Ekete, O., Fapohunda, V., Adetona, O., & Barrat, B. (n.d.).Publication year
2025Journal title
Air Quality, Atmosphere & HealthAbstract~The COVID-19 pandemic and self-reported food insecurity among women in Burkina Faso : evidence from the performance monitoring for action (PMA) COVID-19 survey data
AbstractYankey, O., Essah, M., & Amegbor, P. M. (n.d.).Publication year
2025Journal title
BMC Women's HealthVolume
25Issue
1AbstractBackground: The COVID-19 pandemic led to widespread economic disruptions, with government-imposed restrictions and lockdowns significantly affecting livelihoods globally. Burkina Faso, a country with pre-existing vulnerabilities in food security, experienced considerable challenges during this period. The aim of this study was to examine how COVID-19-related income losses is associated with self-reported food insecurity among women in Burkina Faso in 2020. The study also examined whether there was an increase in self-reported food insecurity among women during the COVID-19 restrictions compared with the pre-pandemic era. Methods: We conducted a cross-sectional analysis using data from the Performance Monitoring for Action (PMA) female survey, which included 3,499 women from Burkina Faso. This study examined the associations between socioeconomic variables, such as age, education, household income loss, and food insecurity. We conducted two analyses using logistic regression. The first analysis focused on self-reported food insecurity and its association with the socioeconomic variables, and the second analysis focused on whether there was an increase in self-reported food insecurity compared with pre-pandemic levels and its association with the socioeconomic factors. We controlled for relevant confounders in the analysis and presented the results as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). Results: Our findings indicated that 16.97% of women reported experiencing food insecurity during the pandemic period. Compared with women with no income loss, women who experienced partial household income loss were 1.82 times (95% CI: 0.98–3.38) more likely to report food insecurity, whereas those who experienced complete income loss were 5.16 times (95% CI: 2.28–9.43) more likely to report food insecurity. The study, however, did not find a statistically significant increase in self-reported food insecurity due to COVID-19 restrictions compared with pre-pandemic levels. Conclusions: This study demonstrated that income loss due to COVID-19 restrictions profoundly affected women’s food security in Burkina Faso. The significant associations between income loss and increased food insecurity underscore the need for targeted interventions and safety nets to support women during public health crises.Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 Causes of Death Collaborators, A., Naghavi, M., Ong, K. L., Aali, A., Ababneh, H. S., Abate, Y. H., Abbafati, C., Abbasgholizadeh, R., Abbasian, M., Abbasi-Kangevari, M., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdelwahab, A., Abdollahi, M., Abdollahifar, M. A., Abdoun, M., Abdulah, D. M., … Peprah, E. K. (n.d.).Publication year
2024Journal title
The LancetVolume
403Issue
10440Page(s)
2100-2132AbstractBackground: Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. Methods: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model—a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates—with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality—which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. Findings: The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2–100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1–290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1–211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4–48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3–37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7–9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. Interpretation: Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. Funding: Bill & Melinda Gates Foundation.Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021
AbstractNaghavi, M., & Amegbor, P. M. (n.d.).Publication year
2024Journal title
The LancetAbstract~Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 Diseases and Injuries Collaborators, A., Ferrari, A. J., Santomauro, D. F., Aali, A., Abate, Y. H., Abbafati, C., Abbastabar, H., Abd ElHafeez, S., Abdelmasseh, M., Abd-Elsalam, S., Abdollahi, A., Abdullahi, A., Abegaz, K. H., Abeldaño Zuñiga, R. A., Aboagye, R. G., Abolhassani, H., Abreu, L. G., Abualruz, H., Abu-Gharbieh, E., … Peprah, E. K. (n.d.).Publication year
2024Journal title
The LancetVolume
403Issue
10440Page(s)
2133-2161AbstractBackground: Detailed, comprehensive, and timely reporting on population health by underlying causes of disability and premature death is crucial to understanding and responding to complex patterns of disease and injury burden over time and across age groups, sexes, and locations. The availability of disease burden estimates can promote evidence-based interventions that enable public health researchers, policy makers, and other professionals to implement strategies that can mitigate diseases. It can also facilitate more rigorous monitoring of progress towards national and international health targets, such as the Sustainable Development Goals. For three decades, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) has filled that need. A global network of collaborators contributed to the production of GBD 2021 by providing, reviewing, and analysing all available data. GBD estimates are updated routinely with additional data and refined analytical methods. GBD 2021 presents, for the first time, estimates of health loss due to the COVID-19 pandemic. Methods: The GBD 2021 disease and injury burden analysis estimated years lived with disability (YLDs), years of life lost (YLLs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries using 100 983 data sources. Data were extracted from vital registration systems, verbal autopsies, censuses, household surveys, disease-specific registries, health service contact data, and other sources. YLDs were calculated by multiplying cause-age-sex-location-year-specific prevalence of sequelae by their respective disability weights, for each disease and injury. YLLs were calculated by multiplying cause-age-sex-location-year-specific deaths by the standard life expectancy at the age that death occurred. DALYs were calculated by summing YLDs and YLLs. HALE estimates were produced using YLDs per capita and age-specific mortality rates by location, age, sex, year, and cause. 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws. Uncertainty was propagated at each step of the estimation process. Counts and age-standardised rates were calculated globally, for seven super-regions, 21 regions, 204 countries and territories (including 21 countries with subnational locations), and 811 subnational locations, from 1990 to 2021. Here we report data for 2010 to 2021 to highlight trends in disease burden over the past decade and through the first 2 years of the COVID-19 pandemic. Findings: Global DALYs increased from 2·63 billion (95% UI 2·44–2·85) in 2010 to 2·88 billion (2·64–3·15) in 2021 for all causes combined. Much of this increase in the number of DALYs was due to population growth and ageing, as indicated by a decrease in global age-standardised all-cause DALY rates of 14·2% (95% UI 10·7–17·3) between 2010 and 2019. Notably, however, this decrease in rates reversed during the first 2 years of the COVID-19 pandemic, with increases in global age-standardised all-cause DALY rates since 2019 of 4·1% (1·8–6·3) in 2020 and 7·2% (4·7–10·0) in 2021. In 2021, COVID-19 was the leading cause of DALYs globally (212·0 million [198·0–234·5] DALYs), followed by ischaemic heart disease (188·3 million [176·7–198·3]), neonatal disorders (186·3 million [162·3–214·9]), and stroke (160·4 million [148·0–171·7]). However, notable health gains were seen among other leading communicable, maternal, neonatal, and nutritional (CMNN) diseases. Globally between 2010 and 2021, the age-standardised DALY rates for HIV/AIDS decreased by 47·8% (43·3–51·7) and for diarrhoeal diseases decreased by 47·0% (39·9–52·9). Non-communicable diseases contributed 1·73 billion (95% UI 1·54–1·94) DALYs in 2021, with a decrease in age-standardised DALY rates since 2010 of 6·4% (95% UI 3·5–9·5). Between 2010 and 2021, among the 25 leading Level 3 causes, age-standardised DALY rates increased most substantially for anxiety disorders (16·7% [14·0–19·8]), depressive disorders (16·4% [11·9–21·3]), and diabetes (14·0% [10·0–17·4]). Age-standardised DALY rates due to injuries decreased globally by 24·0% (20·7–27·2) between 2010 and 2021, although improvements were not uniform across locations, ages, and sexes. Globally, HALE at birth improved slightly, from 61·3 years (58·6–63·6) in 2010 to 62·2 years (59·4–64·7) in 2021. However, despite this overall increase, HALE decreased by 2·2% (1·6–2·9) between 2019 and 2021. Interpretation: Putting the COVID-19 pandemic in the context of a mutually exclusive and collectively exhaustive list of causes of health loss is crucial to understanding its impact and ensuring that health funding and policy address needs at both local and global levels through cost-effective and evidence-based interventions. A global epidemiological transition remains underway. Our findings suggest that prioritising non-communicable disease prevention and treatment policies, as well as strengthening health systems, continues to be crucially important. The progress on reducing the burden of CMNN diseases must not stall; although global trends are improving, the burden of CMNN diseases remains unacceptably high. Evidence-based interventions will help save the lives of young children and mothers and improve the overall health and economic conditions of societies across the world. Governments and multilateral organisations should prioritise pandemic preparedness planning alongside efforts to reduce the burden of diseases and injuries that will strain resources in the coming decades. Funding: Bill & Melinda Gates Foundation.Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990–2021: A systematic analysis for the Global Burden
AbstractAmegbor, P. M. (n.d.).Publication year
2024Journal title
The LancetAbstract~Global, regional, and national burden of stroke and its risk factors, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 Stroke Risk Factor Collaborators, A., Feigin, V. L., Abate, M. D., Abate, Y. H., Abd ElHafeez, S., Abd-Allah, F., Abdelalim, A., Abdelkader, A., Abdelmasseh, M., Abd-Elsalam, S., Abdi, P., Abdollahi, A., Abdoun, M., Abd-Rabu, R., Abdulah, D. M., Abdullahi, A., Abebe, M., Abeldaño Zuñiga, R. A., Abhilash, E. S., … Amegbor, P. M. (n.d.).Publication year
2024Journal title
The Lancet NeurologyVolume
23Issue
10Page(s)
973-1003AbstractBackground: Up-to-date estimates of stroke burden and attributable risks and their trends at global, regional, and national levels are essential for evidence-based health care, prevention, and resource allocation planning. We aimed to provide such estimates for the period 1990–2021. Methods: We estimated incidence, prevalence, death, and disability-adjusted life-year (DALY) counts and age-standardised rates per 100 000 people per year for overall stroke, ischaemic stroke, intracerebral haemorrhage, and subarachnoid haemorrhage, for 204 countries and territories from 1990 to 2021. We also calculated burden of stroke attributable to 23 risk factors and six risk clusters (air pollution, tobacco smoking, behavioural, dietary, environmental, and metabolic risks) at the global and regional levels (21 GBD regions and Socio-demographic Index [SDI] quintiles), using the standard GBD methodology. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In 2021, stroke was the third most common GBD level 3 cause of death (7·3 million [95% UI 6·6–7·8] deaths; 10·7% [9·8–11·3] of all deaths) after ischaemic heart disease and COVID-19, and the fourth most common cause of DALYs (160·5 million [147·8–171·6] DALYs; 5·6% [5·0–6·1] of all DALYs). In 2021, there were 93·8 million (89·0–99·3) prevalent and 11·9 million (10·7–13·2) incident strokes. We found disparities in stroke burden and risk factors by GBD region, country or territory, and SDI, as well as a stagnation in the reduction of incidence from 2015 onwards, and even some increases in the stroke incidence, death, prevalence, and DALY rates in southeast Asia, east Asia, and Oceania, countries with lower SDI, and people younger than 70 years. Globally, ischaemic stroke constituted 65·3% (62·4–67·7), intracerebral haemorrhage constituted 28·8% (28·3–28·8), and subarachnoid haemorrhage constituted 5·8% (5·7–6·0) of incident strokes. There were substantial increases in DALYs attributable to high BMI (88·2% [53·4–117·7]), high ambient temperature (72·4% [51·1 to 179·5]), high fasting plasma glucose (32·1% [26·7–38·1]), diet high in sugar-sweetened beverages (23·4% [12·7–35·7]), low physical activity (11·3% [1·8–34·9]), high systolic blood pressure (6·7% [2·5–11·6]), lead exposure (6·5% [4·5–11·2]), and diet low in omega-6 polyunsaturated fatty acids (5·3% [0·5–10·5]). Interpretation: Stroke burden has increased from 1990 to 2021, and the contribution of several risk factors has also increased. Effective, accessible, and affordable measures to improve stroke surveillance, prevention (with the emphasis on blood pressure, lifestyle, and environmental factors), acute care, and rehabilitation need to be urgently implemented across all countries to reduce stroke burden. Funding: Bill & Melinda Gates Foundation.Global, regional, and national incidence and mortality burden of non-COVID lower respiratory infections and aetiologies, 1990–2021: a systematic analysis from the Global Burden of Disease Study 2021
AbstractAmegbor, P. M. (n.d.).Publication year
2024Journal title
The Lancet Infectious DiseasesAbstract~Global, regional, and national incidence and mortality burden of non-COVID-19 lower respiratory infections and aetiologies, 1990–2021 : a systematic analysis from the Global Burden of Disease Study 2021
AbstractGBD 2021 Lower Respiratory Infections and Antimicrobial Resistance Collaborators, A., Bender, R. G., Sirota, S. B., Swetschinski, L. R., Dominguez, R. M., Novotney, A., Wool, E. E., Ikuta, K. S., Vongpradith, A., Rogowski, E. L., Doxey, M., Troeger, C. E., Albertson, S. B., Ma, J., He, J., Maass, K. L., A.F.Simões, E., Abdoun, M., Abdul Aziz, J. M., … Amuasi, J. H. (n.d.).Publication year
2024Journal title
The Lancet Infectious DiseasesAbstractBackground: Lower respiratory infections (LRIs) are a major global contributor to morbidity and mortality. In 2020–21, non-pharmaceutical interventions associated with the COVID-19 pandemic reduced not only the transmission of SARS-CoV-2, but also the transmission of other LRI pathogens. Tracking LRI incidence and mortality, as well as the pathogens responsible, can guide health-system responses and funding priorities to reduce future burden. We present estimates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 of the burden of non-COVID-19 LRIs and corresponding aetiologies from 1990 to 2021, inclusive of pandemic effects on the incidence and mortality of select respiratory viruses, globally, regionally, and for 204 countries and territories. Methods: We estimated mortality, incidence, and aetiology attribution for LRI, defined by the GBD as pneumonia or bronchiolitis, not inclusive of COVID-19. We analysed 26 259 site-years of mortality data using the Cause of Death Ensemble model to estimate LRI mortality rates. We analysed all available age-specific and sex-specific data sources, including published literature identified by a systematic review, as well as household surveys, hospital admissions, health insurance claims, and LRI mortality estimates, to generate internally consistent estimates of incidence and prevalence using DisMod-MR 2.1. For aetiology estimation, we analysed multiple causes of death, vital registration, hospital discharge, microbial laboratory, and literature data using a network analysis model to produce the proportion of LRI deaths and episodes attributable to the following pathogens: Acinetobacter baumannii, Chlamydia spp, Enterobacter spp, Escherichia coli, fungi, group B streptococcus, Haemophilus influenzae, influenza viruses, Klebsiella pneumoniae, Legionella spp, Mycoplasma spp, polymicrobial infections, Pseudomonas aeruginosa, respiratory syncytial virus (RSV), Staphylococcus aureus, Streptococcus pneumoniae, and other viruses (ie, the aggregate of all viruses studied except influenza and RSV), as well as a residual category of other bacterial pathogens. Findings: Globally, in 2021, we estimated 344 million (95% uncertainty interval [UI] 325–364) incident episodes of LRI, or 4350 episodes (4120–4610) per 100 000 population, and 2·18 million deaths (1·98–2·36), or 27·7 deaths (25·1–29·9) per 100 000. 502 000 deaths (406 000–611 000) were in children younger than 5 years, among which 254 000 deaths (197 000–320 000) occurred in countries with a low Socio-demographic Index. Of the 18 modelled pathogen categories in 2021, S pneumoniae was responsible for the highest proportions of LRI episodes and deaths, with an estimated 97·9 million (92·1–104·0) episodes and 505 000 deaths (454 000–555 000) globally. The pathogens responsible for the second and third highest episode counts globally were other viral aetiologies (46·4 million [43·6–49·3] episodes) and Mycoplasma spp (25·3 million [23·5–27·2]), while those responsible for the second and third highest death counts were S aureus (424 000 [380 000–459 000]) and K pneumoniae (176 000 [158 000–194 000]). From 1990 to 2019, the global all-age non-COVID-19 LRI mortality rate declined by 41·7% (35·9–46·9), from 56·5 deaths (51·3–61·9) to 32·9 deaths (29·9–35·4) per 100 000. From 2019 to 2021, during the COVID-19 pandemic and implementation of associated non-pharmaceutical interventions, we estimated a 16·0% (13·1–18·6) decline in the global all-age non-COVID-19 LRI mortality rate, largely accounted for by a 71·8% (63·8–78·9) decline in the number of influenza deaths and a 66·7% (56·6–75·3) decline in the number of RSV deaths. Interpretation: Substantial progress has been made in reducing LRI mortality, but the burden remains high, especially in low-income and middle-income countries. During the COVID-19 pandemic, with its associated non-pharmaceutical interventions, global incident LRI cases and mortality attributable to influenza and RSV declined substantially. Expanding access to health-care services and vaccines, including S pneumoniae, H influenzae type B, and novel RSV vaccines, along with new low-cost interventions against S aureus, could mitigate the LRI burden and prevent transmission of LRI-causing pathogens. Funding: Bill & Melinda Gates Foundation, Wellcome Trust, and Department of Health and Social Care (UK).Modelling the spatial risk pattern of dementia in Denmark using residential location data : A registry-based national cohort
AbstractAmegbor, P. M., Sabel, C. E., Mortensen, L. H., & Mehta, A. J. (n.d.).Publication year
2024Journal title
Spatial and Spatio-temporal EpidemiologyVolume
49AbstractDementia is a major global public health concern that is increasingly leading to morbidity and mortality among older adults. While studies have focused on the risk factors and care provision, there is currently limited knowledge about the spatial risk pattern of the disease. In this study, we employ Bayesian spatial modelling with a stochastic partial differential equation (SPDE) approach to model the spatial risk using complete residential history data from the Danish population and health registers. The study cohort consisted of 1.6 million people aged 65 years and above from 2005 to 2018. The results of the spatial risk map indicate high-risk areas in Copenhagen, southern Jutland and Funen. Individual socioeconomic factors and population density reduce the intensity of high-risk patterns across Denmark. The findings of this study call for the critical examination of the contribution of place of residence in the susceptibility of the global ageing population to dementia.Smoke Exposure, Haemoglobin Levels, and the Prevalence of Anaemia: a Cross-sectional Study in Urban Informal Settlement in Southern Ghana
AbstractAppiah-Dwomoh , C., Tettey , P., Akyeampong , E., Amegbor, P. M., Okello,G. , Botwe, P., & Quansah, R. (n.d.).Publication year
2024Journal title
BMC Public HealthAbstract~Smoke exposure, hemoglobin levels and the prevalence of anemia : a cross-sectional study in urban informal settlement in Southern Ghana
AbstractAppiah-Dwomoh, C., Tettey, P., Akyeampong, E., Amegbor, P. M., Okello, G., Botwe, P. K., & Quansah, R. (n.d.).Publication year
2024Journal title
BMC public healthVolume
24Issue
1AbstractBackground: In sub-Saharan African cities, more than half of the population lives in informal settlements. These settlements are close to smoky dumpsites, industrial plants, and polluted roads. Furthermore, polluting fuels remain their primary sources of energy for cooking and heating. Despite evidence linking smoke and its components to anaemia, none of these studies were conducted on populations living in urban informal settlements. This study investigated the risks of anemia/mean Haemoglobin (HB) levels in an informal settlement in Accra, Ghana. Exposure to smoke was examined across various sources, encompassing residences, neighborhoods, and workplaces. Methods: The study was a facility-based cross-sectional design among residents at Chorkor, an informal settlement in the Greater Accra region of Ghana. A questionnaire was administered at a community hospital during an interview to gather data on sources of smoke exposure in the household, in the neighbourhood, and in the workplace. A phlebotomist collected blood samples from the participants after the interview to assess their anaemia status. Results: The population (n = 320) had a high prevalence of anemia, with 49.1% of people fitting the WHO’s definition of anemia, while the average HB level was 12.6 ± 2.1 g/dL. Anemia was associated with the number of different types of waste burnt simultaneously [(1 or 2: prevalence ratio (PR): 95% confidence interval (CI), 1.14, 0.99–1.28: 3+: 1.16, 1.01–1.63, p-for-trend = 0.0082)], fuel stacking [(mixed stacking: 1.27, 1.07–1.20: dirty stacking:1.65, 1.19–2.25, p-for-trend = 0.0062)], and involvement in fish smoking (1.22, 0.99–1.06). However, the lower limit of the CIs for number of different forms of garbage burned simultaneously and engagement in fish smoking included unity. Reduced mean HB levels were associated with the number of different types of waste burnt simultaneously [(1 or 2: regression coefficient (β): 95% confidence interval (CI), -0.01, -0.97- -0.99: 3+: -0.14, -0.77- -0.05)], current smoker [(yes, almost daily: -1.40, -2.01- -0.79: yes, at least once a month: -1.14, -1.79- -0.48)], Second-Hand-Smoking (SHS) (yes, almost daily: -0.77, -1.30- -0.21), fuel stacking [(mixed stacking-0.93, -1.33–0.21: dirty stacking-1.04, -1.60- -0.48)], any smoke exposure indicator in the neighbourhood (-0.84, -1.43- -0.25), living close to a major road (-0.62, -1.09- -0.49), and fish smoking (-0.41,-0.93- -0.12). Conclusion: Although the cross-sectional design precludes causality, smoke exposure was associated with mean HB levels and anaemia among populations living in informal settlements.Spatial modelling of psychosocial benefits of favourite places in Denmark : A tale of two cities
AbstractAmegbor, P. M., Dalgaard, R., Nainggolan, D., Jensen, A., Sabel, C. E., Panduro, T. E., Jensen, M. S., Dybdal, A. E., & Puig, M. (n.d.).Publication year
2024Journal title
Environment and Planning B: Urban Analytics and City ScienceAbstractLiving in urban areas is known to increase the risk of psychosocial disorders, including stress, depression, and anxiety. Existing studies suggest that experiential places, including places of interest or favourite places, can mitigate these negative effects on psychological and physical health often associated with urban living. This study aims to model the spatial patterns of the benefits derived from favourite locations in two cities in Denmark: an urban metropolitan area (the capital city) and a provincial commuter town. Additionally, it examines the influence of individual and household socioeconomic factors on the benefits derived from these favourite places. Employing an online Public Participatory Geographic Information System (PPGIS) approach, data on favourite locations, derived benefits, and socioeconomic characteristics of 1400 respondents were collected. Bayesian modelling with Stochastic Partial Differential Equations under the Integrated Nested Laplace Approximation framework (INLA-SPDE) was utilized to predict the spatial patterns of four types of benefits – restorative, physical activity, socializing, and cultural – associated with enjoying favourite places in the two municipalities. This geostatistical approach allows for the identification of specific locations within the cities with perceived benefits and areas lacking such benefits. The findings provide insights into potential inequalities in the spatial distribution of perceived benefits of favourite places in Copenhagen and Roskilde, thereby informing urban planning policies and programs aimed at addressing these disparities.The burden of diseases, injuries, and risk factors by state in the USA, 1990–2021 : a systematic analysis for the Global Burden of Disease Study 2021
AbstractGBD 2021 US Burden of Disease Collaborators, A., Mokdad, A. H., Bisignano, C., Hsu, J. M., Aldridge, R. W., Aravkin, A. Y., Brauer, M., Bryazka, D., Cagney, J., Cogen, R. M., Culbreth, G. T., Dai, X., Daoud, F., Degenhardt, L., Dwyer-Lindgren, L., Feigin, V. L., Flor, L. S., Fu, W., Gardner, W. M., … Peprah, E. K. (n.d.).Publication year
2024Journal title
The LancetVolume
404Issue
10469Page(s)
2314-2340AbstractBackground: The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides a comprehensive assessment of health and risk factor trends at global, regional, national, and subnational levels. This study aims to examine the burden of diseases, injuries, and risk factors in the USA and highlight the disparities in health outcomes across different states. Methods: GBD 2021 analysed trends in mortality, morbidity, and disability for 371 diseases and injuries and 88 risk factors in the USA between 1990 and 2021. We used several metrics to report sources of health and health loss related to specific diseases, injuries, and risk factors. GBD 2021 methods accounted for differences in data sources and biases. The analysis of levels and trends for causes and risk factors within the same computational framework enabled comparisons across states, years, age groups, and sex. GBD 2021 estimated years lived with disability (YLDs) and disability-adjusted life-years (DALYs; the sum of years of life lost to premature mortality and YLDs) for 371 diseases and injuries, years of life lost (YLLs) and mortality for 288 causes of death, and life expectancy and healthy life expectancy (HALE). We provided estimates for 88 risk factors in relation to 155 health outcomes for 631 risk–outcome pairs and produced risk-specific estimates of summary exposure value, relative health risk, population attributable fraction, and risk-attributable burden measured in DALYs and deaths. Estimates were produced by sex (male and female), age (25 age groups from birth to ≥95 years), and year (annually between 1990 and 2021). 95% uncertainty intervals (UIs) were generated for all final estimates as the 2·5th and 97·5th percentiles values of 500 draws (ie, 500 random samples from the estimate's distribution). Uncertainty was propagated at each step of the estimation process. Findings: We found disparities in health outcomes and risk factors across US states. Our analysis of GBD 2021 highlighted the relative decline in life expectancy and HALE compared with other countries, as well as the impact of COVID-19 during the first 2 years of the pandemic. We found a decline in the USA's ranking of life expectancy from 1990 to 2021: in 1990, the USA ranked 35th of 204 countries and territories for males and 19th for females, but dropped to 46th for males and 47th for females in 2021. When comparing life expectancy in the best-performing and worst-performing US states against all 203 other countries and territories (excluding the USA as a whole), Hawaii (the best-ranked state in 1990 and 2021) dropped from sixth-highest life expectancy in the world for males and fourth for females in 1990 to 28th for males and 22nd for females in 2021. The worst-ranked state in 2021 ranked 107th for males (Mississippi) and 99th for females (West Virginia). 14 US states lost life expectancy over the study period, with West Virginia experiencing the greatest loss (2·7 years between 1990 and 2021). HALE ranking declines were even greater; in 1990, the USA was ranked 42nd for males and 32nd for females but dropped to 69th for males and 76th for females in 2021. When comparing HALE in the best-performing and worst-performing US states against all 203 other countries and territories, Hawaii ranked 14th highest HALE for males and fifth for females in 1990, dropping to 39th for males and 34th for females in 2021. In 2021, West Virginia—the lowest-ranked state that year—ranked 141st for males and 137th for females. Nationally, age-standardised mortality rates declined between 1990 and 2021 for many leading causes of death, most notably for ischaemic heart disease (56·1% [95% UI 55·1–57·2] decline), lung cancer (41·9% [39·7–44·6]), and breast cancer (40·9% [38·7–43·7]). Over the same period, age-standardised mortality rates increased for other causes, particularly drug use disorders (878·0% [770·1–1015·5]), chronic kidney disease (158·3% [149·6–167·9]), and falls (89·7% [79·8–95·8]). We found substantial variation in mortality rates between states, with Hawaii having the lowest age-standardised mortality rate (433·2 per 100 000 [380·6–493·4]) in 2021 and Mississippi having the highest (867·5 per 100 000 [772·6–975·7]). Hawaii had the lowest age-standardised mortality rates throughout the study period, whereas Washington, DC, experienced the most improvement (a 40·7% decline [33·2–47·3]). Only six countries had age-standardised rates of YLDs higher than the USA in 2021: Afghanistan, Lesotho, Liberia, Mozambique, South Africa, and the Central African Republic, largely because the impact of musculoskeletal disorders, mental disorders, and substance use disorders on age-standardised disability rates in the USA is so large. At the state level, eight US states had higher age-standardised YLD rates than any country in the world: West Virginia, Kentucky, Oklahoma, Pennsylvania, New Mexico, Ohio, Tennessee, and Arizona. Low back pain was the leading cause of YLDs in the USA in 1990 and 2021, although the age-standardised rate declined by 7·9% (1·8–13·0) from 1990. Depressive disorders (56·0% increase [48·2–64·3]) and drug use disorders (287·6% [247·9–329·8]) were the second-leading and third-leading causes of age-standardised YLDs in 2021. For females, mental health disorders had the highest age-standardised YLD rate, with an increase of 59·8% (50·6–68·5) between 1990 and 2021. Hawaii had the lowest age-standardised rates of YLDs for all sexes combined (12 085·3 per 100 000 [9090·8–15 557·1]), whereas West Virginia had the highest (14 832·9 per 100 000 [11 226·9–18 882·5]). At the national level, the leading GBD Level 2 risk factors for death for all sexes combined in 2021 were high systolic blood pressure, high fasting plasma glucose, and tobacco use. From 1990 to 2021, the age-standardised mortality rates attributable to high systolic blood pressure decreased by 47·8% (43·4–52·5) and for tobacco use by 5·1% (48·3%–54·1%), but rates increased for high fasting plasma glucose by 9·3% (0·4–18·7). The burden attributable to risk factors varied by age and sex. For example, for ages 15–49 years, the leading risk factors for death were drug use, high alcohol use, and dietary risks. By comparison, for ages 50–69 years, tobacco was the leading risk factor for death, followed by dietary risks and high BMI. Interpretation: GBD 2021 provides valuable information for policy makers, health-care professionals, and researchers in the USA at the national and state levels to prioritise interventions, allocate resources effectively, and assess the effects of health policies and programmes. By addressing socioeconomic determinants, risk behaviours, environmental influences, and health disparities among minority populations, the USA can work towards improving health outcomes so that people can live longer and healthier lives. Funding: Bill & Melinda Gates Foundation.Assessing the association between overcrowding and human physiological stress response in different urban contexts : a case study in Salzburg, Austria
AbstractZhang, Z., Měchurová, K., Resch, B., Amegbor, P. M., & Sabel, C. E. (n.d.).Publication year
2023Journal title
International Journal of Health GeographicsVolume
22Issue
1AbstractOvercrowding in densely populated urban areas is increasingly becoming an issue for mental health disorders. Yet, only few studies have examined the association between overcrowding in cities and physiological stress responses. Thus, this study employed wearable sensors (a wearable camera, an Empatica E4 wristband and a smartphone-based GPS) to assess the association between overcrowding and human physiological stress response in four types of urban contexts (green space, transit space, commercial space, and blue space). A case study with 26 participants was conducted in Salzburg, Austria. We used Mask R-CNN to detect elements related to overcrowding such as human crowds, sitting facilities, vehicles and bikes from first-person video data collected by wearable cameras, and calculated a change score (CS) to assess human physiological stress response based on galvanic skin response (GSR) and skin temperature from the physiological data collected by the wristband, then this study used statistical and spatial analysis to assess the association between the change score and the above elements. The results demonstrate the feasibility of using sensor-based measurement and quantitative analysis to investigate the relationship between human stress and overcrowding in relation to different urban elements. The findings of this study indicate the importance of considering human crowds, sitting facilities, vehicles and bikes to assess the impact of overcrowding on human stress at street level.Associations between early-life exposure to ambient air pollution and childhood health outcomes: Exploring potential spatial heterogeneity
AbstractAmegbor, P. M. (n.d.).Publication year
2023AbstractAt the 2023 APHA annual meeting, I delivered a roundtable presentation centered on the impact of early-life exposure to ambient air pollutants on childhood health outcomes among children under 5 in Sub-Saharan Africa (SSA). The presentation delved into the Developmental Origins of Health and Disease (DOHaD) theory, which posits that exposure to adverse environmental factors during early life can significantly influence short- and long-term health outcomes. Specifically, the talk highlighted the application of spatial variation coefficient models as a tool to investigate disparities in the impact or effect of early-life ambient air pollution exposure on health.Early-life air pollution and green space exposures as determinants of stunting among children under age five in Sub-Saharan Africa
AbstractAmegbor, P. M., Sabel, C. E., Mortensen, L. H., Mehta, A. J., & Rosenberg, M. W. (n.d.).Publication year
2023Journal title
Journal of Exposure Science and Environmental EpidemiologyAbstractBackground: Childhood malnutrition is a major public health issue in Sub-Saharan Africa (SSA) and 61.4 million children under the age of five years in the region are stunted. Although insight from existing studies suggests plausible pathways between ambient air pollution exposure and stunting, there are limited studies on the effect of different ambient air pollutants on stunting among children. Objective: Explore the effect of early-life environmental exposures on stunting among children under the age of five years. Methods: In this study, we used pooled health and population data from 33 countries in SSA between 2006 and 2019 and environmental data from the Atmospheric Composition Analysis Group and NASA’s GIOVANNI platform. We estimated the association between early-life environmental exposures and stunting in three exposure periods – in-utero (during pregnancy), post-utero (after pregnancy to current age) and cumulative (from pregnancy to current age), using Bayesian hierarchical modelling. We also visualise the likelihood of stunting among children based on their region of residence using Bayesian hierarchical modelling. Results: The findings show that 33.6% of sampled children were stunted. In-utero PM2.5 was associated with a higher likelihood of stunting (OR = 1.038, CrI = 1.002–1.075). Early-life exposures to nitrogen dioxide and sulphate were robustly associated with stunting among children. The findings also show spatial variation in a high and low likelihood of stunting based on a region of residence. Impact Statement: This study explores the effect of early-life environmental exposures on child growth or stunting among sub-Saharan African children. The study focuses on three exposure windows – pregnancy, after birth and cumulative exposure during pregnancy and after birth. The study also employs spatial analysis to assess the spatial burden of stunted growth in relation to environmental exposures and socioeconomic factors. The findings suggest major air pollutants are associated with stunted growth among children in sub-Saharan Africa.Global Burden of Cardiovascular Diseases and Risks, 1990-2022
AbstractGlobal Burden of Cardiovascular Diseases and Risks Collaborators, A., Mensah, G. A., Habtegiorgis Abate, Y., Abbasian, M., Abd-Allah, F., Abdollahi, A., Abdollahi, M., Morad Abdulah, D., Abdullahi, A., Abebe, A. M., Abedi, A., Abedi, A., Olusola Abiodun, O., Ali, H. A., Abu-Gharbieh, E., Abu-Rmeileh, N. M., Aburuz, S., Abushouk, A. I., Abu-Zaid, A., … Peprah, E. K. (n.d.).Publication year
2023Journal title
Journal of the American College of CardiologyVolume
82Issue
25Page(s)
2350-2473Abstract~Global Burden of Cardiovascular Diseases and Risks, 1990-2022
AbstractAmegbor, P. M., Mensah, G. A., Fuster, V., Murray, C. J., & Roth, G. A. (n.d.).Publication year
2023Volume
82Abstract~Reducing Dietary Sodium Intake among Young Adults in Ghana : A Call to Action
AbstractPeprah, E., Amegbor, P. M., Laar, A., Akasoe, B., & Commodore-Mensah, Y. (n.d.).Publication year
2023Journal title
NutrientsVolume
15Issue
16AbstractThe positive association between excessive dietary sodium intake, hypertension, and cardiovascular disease (CVD) has been widely investigated in observational studies and clinical trials. Reducing sodium intake is a proven strategy to prevent hypertension and the onset of CVD, a major cause of morbidity and mortality globally. Africa has the youngest population globally, which is key to the continent’s sustainable development. However, in Africa, the epidemics of hypertension and CVD negatively impact life expectancy and economic growth. Ghana, like other African countries, is no exception. The factors contributing to the increasing burden of CVD and excessive sodium consumption are multi-faceted and multi-level, including individual lifestyle, neighborhood and built environments, and socio-economic and health policies. Thus, the implementation of evidence-based interventions such as the World Health Organization Best Buys that target the multi-level determinants of sodium consumption is urgently needed in Ghana and other African countries. The aim of this commentary is to highlight factors that contribute to excessive sodium consumption. Second, the commentary will showcase lessons of successful implementation of sodium reduction interventions in other countries. Such lessons may help avert CVD in young adults in Ghana and Africa.