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
Health and socioeconomic risk factors for overnight admission among older adults in Ghana
AbstractAmegbor, P. M., & Rosenberg, M. W. (n.d.).Publication year
2020Journal title
Journal of Population AgeingAbstractGhana’s older adult population is growing significantly. However, there is limited knowledge or research on the effect of place, chronic health conditions, and socioeconomic status on the risk of overnight hospital admission or the frequency of hospitalisation among older adults in Ghana. Using the WHO SAGE (Wave 1) data, we examine the influence of place of residence, chronic health conditions, and socioeconomic status on overnight hospital admission, as well as, frequency of hospital admission among older adults in Ghana. Multivariate logistic regression and zero-inflated negative binomial regression models were used to study the influence of place, health conditions, and socioeconomic status on overnight hospital admission. The findings show that older adults with functional limitations and chronical health conditions were more likely to have experienced an overnight hospital admission. The expected number of overnight hospital admission was greater among chronically ill older adults than their healthy counterparts. However, the findings show that socioeconomically vulnerable older adults were less likely to have overnight hospital admission and they had lower admission rates. The presence of chronic health conditions is associated with overnight hospital admission, while poor socioeconomic status may imply underutilization or limited access to healthcare for the socioeconomically vulnerable.Individual and contextual predictors of overweight or obesity among women in Uganda : a spatio-temporal perspective
AbstractAmegbor, P. M., Yankey, O., Davies, M., & Sabel, C. E. (n.d.).Publication year
2022Journal title
GeoJournalVolume
87Issue
5Page(s)
3793-3813AbstractBeing overweight and obesity are emerging public health issues in sub-Saharan Africa. Currently, there is limited knowledge on the temporal trend of the effect of socioeconomic factors and air quality on being overweight or obesity. Using data from the Ugandan Demographic and Health Survey and NASA’s Socioeconomic Data and Applications Center (SEDAC), we examined the spatio-temporal effect of individual and contextual factors on overweight and obesity among women in Uganda using cross-sectional data on 15,655 women in Uganda. We employed multilevel mixed-effect analysis and Bayesian hierarchical spatial models to examine the effect of individual socioeconomic status, contextual socioeconomic factors and air quality on women’s risk of being overweight or obese as well as investigate spatial heterogeneity in the association. The prevalence of overweight/obesity for the study periods were 17.23% (2000/2001), 15.36% (2006), 19.36% (2011) and 21.93% (2016). The result from the multilevel analysis shows change in the directions of the association between individual factors (educational status and household wealth) and overweight or obese over the years. Women with secondary education were 1.514 times (p = 0.002) more likely to be overweight or obese in the 2000/2001 group but 0.655 times (p = 0.007) less likely to be overweight or obese in the 2016 group. It also reveals temporal consistency in the effect of the air pollutant PM2.5 on overweight or obese. The spatial models reveal spatial heterogeneity in the association between district-level factors and the proportion of overweight or obese women. The findings suggest improving women’s socioeconomic status and air quality could reduce the rising obesity epidemic in Ugandan women.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.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.Modern or traditional health care? Understanding the role of insurance in health-seeking behaviours among older Ghanaians
AbstractAmegbor, P. M., Kuuire, V. Z., Bisung, E., & Braimah, J. A. (n.d.).Publication year
2019Journal title
Primary health care research & developmentVolume
20Page(s)
e71AbstractAIM: This paper examined the association between wealth and health insurance status and the use of traditional medicine (TM) among older persons in Ghana. BACKGROUND: There have been considerable efforts by sub-Saharan African countries to improve access to primary health care services, partly through the implementation of risk-pooling community or national health insurance schemes. The use of TM, which is often not covered under these insurance schemes, remains common in many countries, including Ghana. Understanding how health insurance and wealth influence the use of TM, or otherwise, is essential to the development of equitable health care policies. METHODS: The study used data from the first wave of the World Health Organisation's Study of Global Ageing and Adult Health conducted in Ghana in 2008. Descriptive statistics and negative loglog regression models were fitted to the data to examine the influence of insurance and wealth status on the use of TM, controlling for theoretically relevant factors. FINDINGS: Seniors who had health insurance coverage were also 17% less likely to frequently seek treatment from a TM healer relative to the uninsured. For older persons in the poorest income quintile, the odds of frequently seeking treatment from TM increased by 61% when compared to those in the richest quintile. This figure was 46%, 62% and 40% for older persons in poorer, middle and richer income quintiles, respectively, compared to their counterparts in the richest income quintile. CONCLUSION: The findings indicate that TM was primarily used by the poor and persons who were not enrolled in the National Health Insurance Scheme. TM continues to be a vital health care resource for the poor and uninsured older adults in Ghana.Multilevel and spatial analyses of childhood malnutrition in Uganda : examining individual and contextual factors
AbstractAmegbor, P. M., Zhang, Z., Dalgaard, R., & Sabel, C. E. (n.d.).Publication year
2020Journal title
Scientific reportsVolume
10Issue
1AbstractIn this study, we examine the concepts of spatial dependence and spatial heterogeneity in the effect of macro-level and micro-level factors on stunting among children aged under five in Uganda. We conducted a cross-sectional analysis of 3624 Ugandan children aged under five, using data from the 2016 Ugandan Demographic and Health Survey. Multilevel mixed-effect analysis, spatial regression methods and multi-scale geographically weight regression (MGWR) analysis were employed to examine the association between our predictors and stunting as well as to analyse spatial dependence and variability in the association. Approximately 28% of children were stunted. In the multilevel analysis, the effect of drought, diurnal temperature and livestock per km2 on stunting was modified by child, parent and household factors. Likewise, the contextual factors had a modifiable effect on the association between child’s sex, mother’s education and stunting. The results of the spatial regression models indicate a significant spatial error dependence in the residuals. The MGWR suggests rainfall and diurnal temperature had spatial varying associations with stunting. The spatial heterogeneity of rainfall and diurnal temperature as predictors of stunting suggest some areas in Uganda might be more sensitive to variability in these climatic conditions in relation to stunting than others.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~Predictors of basic self-care and intermediate self-care functional disabilities among older adults in Ghana
AbstractAmegbor, P. M., Kuuire, V. Z., Robertson, H., & Kuffuor, O. A. (n.d.).Publication year
2018Journal title
Archives of Gerontology and GeriatricsVolume
77Page(s)
81-88AbstractThe number of older adults in Ghana is growing rapidly. Associated with this growth, is the rise in age-related chronic diseases such as cardiovascular and musculoskeletal conditions. However, there is limited knowledge in the Ghanaian context on the effect of chronic diseases on functional disabilities among older adults. In this study, we examine the association between chronic diseases, socioeconomic status, and functional disabilities. Data from 4107 Ghanaian older adults (persons aged 50 years and above) who participated in the World Health Organization's Global Ageing and Adult Health survey (SAGE-Wave 1) were used to fit random effect multivariate logistic and complementary log-log regression. Stroke was significantly associated with difficulty in performing both basic self-care functions and intermediate self-care functions. Hypertension and arthritis, on the other hand, were associated with basic self-care functional disability only. Socioeconomically vulnerable groups such as females, those with less education and low-incomes were more likely to have functional disabilities associated with basic self-care and intermediate self-care activities. In order to reduce functional disabilities among older persons in Ghana, efforts should be aimed at reducing chronic conditions as well as improving socioeconomic status.Predictors of Unmet Traditional, Complementary and Alternative Medicine Need Among Persons of Sub-Saharan African Origin Living in the Greater Toronto Area
AbstractAmegbor, P. M., & Rosenberg, M. W. (n.d.).Publication year
2020Journal title
Journal of Immigrant and Minority HealthVolume
22Issue
5Page(s)
1031-1038AbstractOur study seeks to examine how chronic health status, insurance coverage and socioeconomic factors predict unmet traditional, complementary and alternative medicine (TCAM) needs among immigrants from sub-Saharan African origin living in the Greater Toronto Area (GTA). The data for the study comes from a cross-sectional questionnaire survey of 273 sub-Saharan African immigrants living in the GTA. ~ 21% of respondents surveyed had unmet TCAM needs in the 12-month period prior to the survey. Persons with chronic health conditions, lower socioeconomic status, and those with previous history of TCAM use before immigrating were more likely to have unmet TCAM need. The study suggests that the current TCAM healthcare environment in the GTA limits that ability of sub-Saharan immigrants to meet their healthcare needs, especially persons in most need of such treatments—persons with chronic health conditions and those of lower socioeconomic background.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.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.Social Frailty and Depression Among Older Adults in Ghana : Insights from the WHO SAGE Surveys
AbstractAmegbor, P. M., Kuuire, V. Z., Yawson, A. E., Rosenberg, M. W., & Sabel, C. E. (n.d.).Publication year
2021Journal title
Research on AgingVolume
43Issue
2Page(s)
85-95AbstractIn this study, we examine the association between social frailty and depression among older adults in Ghana over time. We employed longitudinal data analysis to examine the association between social frailty, socioeconomic status and depression using data from the WHO-SAGE survey. Our descriptive and cross-tabulation analyses show that the prevalence of depression and social frailty among older adults decreased considerably in 2014/2015 compared to 2007/2008. The finding also reveals a huge reduction in social frailty among older adults in northern Ghana–the most deprived regions in Ghana–compared to those in southern Ghana. The multivariate panel data analysis reveals that depression was significantly associated with social isolation, financial needs, and physical needs. The findings suggest an over time decline in social frailty and depression among older adults, as well as, reduction in regional differences in social frailty and depression among older adults in Ghana.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.Spatiotemporal analysis of the effect of global development indicators on child mortality
AbstractAmegbor, P. M., & Addae, A. (n.d.).Publication year
2023Journal title
International Journal of Health GeographicsVolume
22Issue
1AbstractBackground: Child mortality continue to be a major public health issue in most developing countries; albeit there has been a decline in global under-five deaths. The differences in child mortality can best be explained by socioeconomic and environmental inequalities among countries. In this study, we explore the effect of country-level development indicators on under-five mortality rates. Specifically, we examine potential spatio-temporal heterogeneity in the association between major world development indicators on under-five mortality, as well as, visualize the global differential time trend of under-five mortality rates. Methods: The data from 195 countries were curated from the World Bank’s World Development Indicators (WDI) spanning from 2000 to 2017 and national estimates for under-five mortality from the UN Inter-agency Group for Child Mortality Estimation (UN IGME).We built parametric and non-parametric Bayesian space-time interaction models to examine the effect of development indicators on under-five mortality rates. We also used employed Bayesian spatio-temporal varying coefficient models to assess the spatial and temporal variations in the effect of development indicators on under-five mortality rates. Results: In both parametric and non-parametric models, the results show indicators of good socioeconomic development were associated with a reduction in under-five mortality rates while poor indicators were associated with an increase in under-five mortality rates. For instance, the parametric model shows that gross domestic product (GDP) (β = − 1.26, [CI − 1.51; − 1.01]), current healthcare expenditure (β = − 0.40, [CI − 0.55; − 0.26]) and access to basic sanitation (β = − 0.03, [CI − 0.05; − 0.01]) were associated with a reduction under-five mortality. An increase in the proportion practising open defecation (β = 0.14, [CI 0.08; 0.20]) an increase under-five mortality rate. The result of the spatial components spatial variation in the effect of the development indicators on under-five mortality rates. The spatial patterns of the effect also change over time for some indicators, such as PM2.5. Conclusion: The findings show that the burden of under-five mortality rates was considerably higher among sub-Saharan African countries and some southern Asian countries. The findings also reveal the trend in reduction in the sub-Saharan African region has been slower than the global trend.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~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.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.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
AbstractAmegbor, P. M., Yankey, O., Essah, M., & Amegbor, P. M. (n.d.).Journal title
BMC WOMENS HEALTHAbstract~The effect of sociodemographic factors on the risk of poor mental health in Akron (Ohio) : A Bayesian hierarchical spatial analysis
AbstractYankey, O., Amegbor, P. M., & Lee, J. (n.d.).Publication year
2021Journal title
Spatial and Spatio-temporal EpidemiologyVolume
38AbstractWe examined the association of sociodemographic factors on mental health risk within the city of Akron (Ohio). A Spatial Bayesian Hierarchical model was used in this study. We found that the risk of poor mental health was positively associated with the proportion of people lacking sufficient sleep (RR = 0.42, 95% CI:0.22-0.62), the percentage of people below poverty (RR = 0.12, 95% CI: 0.09, 0.16), and the percentage of married couples (RR = 0.02, 95% CI: -0.05, 0.08). On the contrary, the percentage of female population (RR = -0.06, 95% CI: -0.13, 0.01), the percentage of the black population (RR = -0.05, 95% CI: -0.08, -0.02), and the college-educated population (RR = -0.03, 95% CI: -0.09, 0.04) was negatively associated with the risk of poor mental health. We also found that the sociodemographic variables have spatially varying effects across different neighborhoods. Future studies will examine the joint spatial effect of poor mental health risk and suicide ideation in the study area.The effect of socioeconomic and environmental factors on obesity : A spatial regression analysis
AbstractYankey, O., Amegbor, P. M., & Essah, M. (n.d.).Publication year
2021Journal title
International Journal of Applied Geospatial ResearchVolume
12Issue
4Page(s)
58-74AbstractThis paper examined the effect of socio-economic and environmental factors on obesity in Cleveland (Ohio) using an OLS model and three spatial regression models: spatial error model, spatial lag model, and a spatial error model with a spatially lagged response (SEMSLR). Comparative assessment of the models showed that the SEMSLR and the spatial error models were the best models. The spatial effect from the various spatial regression models was statistically significant, indicating an essential spatial interaction among neighboring geographic units and the need to account for spatial dependency in obesity research. The authors also found a statistically significant positive association between the percentage of families below poverty, Black population, and SNAP recipient with obesity rate. The percentage of college-educated had a statistically significant negative association with the obesity rate. The study shows that health outcomes such as obesity are not randomly distributed but are more clustered in deprived and marginalized neighborhoods.The use of dental care services in Alberta, Manitoba, and Newfoundland and Labrador : A comparative analysis
AbstractAmegbor, P. M., & Rosenberg, M. W. (n.d.). In Canadian Geographer.Publication year
2018Volume
62Issue
3Page(s)
414-426AbstractPublic support for dental care in Canada is uniform. Universal coverage and access to health care in the country are narrowly limited to hospital-based and physician-based services—“medically necessary services.” In view of the variations in public support programs for dental care, our study examines differences in the use of dental care services among different socio-economic groups in Alberta, Manitoba, and Newfoundland and Labrador. The study used 2012 Canadian Community Health Survey data. Our analyses find that in all the three provinces persons of lower socio-economic status have lower utilization of dental care. However, the study further reveals that the gaps between age and household income groups was wider in Newfoundland and Labrador compared to the other provinces. These findings suggest that public support for dental care reduces socio-economic disparities in the use of dental services.Understanding unmet health-care need among older Ghanaians : A gendered analysis
AbstractKuuire, V. Z., Tenkorang, E. Y., Amegbor, P. M., & Rosenberg, M. (n.d.).Publication year
2021Journal title
Ageing and SocietyVolume
41Issue
8Page(s)
1748-1769AbstractHealth insurance schemes are important for bridging gaps in health-care needs between the rich and poor, especially in contexts where poverty is higher among seniors (persons aged 65 years and above). In this study we examined (a) gender-based predictors of unmet health-care need among seniors and (b) whether access was influenced by wealth status (measured by income quintiles). Gender-specific negative log-log regression models were fitted to data from the Study on Global Ageing and Health to examine associations between unmet health-care need and health insurance status controlling for theoretically relevant covariates. Insurance status was an important determinant of men and women's unmet health-care need but the relationship was moderated by income quintile for women and not men. While occupation was important for men, religion, marital status and income quintile were significantly associated with women's unmet health-care need. Based on the observed gender differences, we recommend the implementation of programmes aimed at improving the economic situation of older people, particularly women.Understanding usage and preference for health care therapies in a Ghanaian context : A pluralistic perspective
AbstractAmegbor, P. M. (n.d.).Publication year
2017Journal title
Norsk Geografisk TidsskriftVolume
71Issue
5Page(s)
288-300AbstractStudies of health care and health-care seeking behaviour in Ghana have mainly shown that many patients tend to use indigenous medicine to address their health care needs. These studies have cited affordability, acceptability, availability, and accessibility as major factors behind the predominant use of indigenous medicine. Nevertheless, in these studies, researchers often ignore the third health care option–self-care, usually subjugated under the indigenous medical system. Since the mid-1980s, both biomedical and indigenous health care systems have witnessed transformations that have shaped and changed their modes of operation, as well as the cost of treatment. In light of this, the author seeks to understand the motivations behind the preference for and use of self-care, professional biomedical care, and indigenous forms of care in the context of Ghana’s health care system. A qualitative, in-depth interview technique was used for data gathering. Findings from the study revealed that time and cost of treatment were major factors accounting for the predominant use of self-care. The author concludes that the findings challenge the long-held belief that biomedicine is not widely accepted by people in Ghana compared with indigenous medicine.