Interrogating the environmental and social correlates of health risk behaviours in West Africa

Abstract Background Despite the high incidences of health risk behaviors (HRBs) in sub-Saharan Africa, studies on the contextual determinants of HRBs across countries are generally lacking, concentrated on isolated countries and often focus solely on specific health behaviors. Thus, this study investigated the environmental and social correlates of HRBs in West Africa. Methods Data was from post-2015 Demographic and Health Surveys in three West African countries of Benin, Mali and Nigeria. A composite outcome variable of health risk behaviors (HRBs) was derived from variables of tobacco smoking, intimate partner violence, overweight/obesity and risky sexual behaviors. The contextual variables were normalized difference vegetation index, precipitation, maximum and minimum temperatures, region of residence and population Density. Data analysis involved descriptive statistics, chi square test, geographical mapping, and multilevel logistic regression. Results The engagement in HRBs varied from 42.65% in Nigeria to 42.88% in Benin and 51.06% in Mali as there are spatial variations in the engagement in HRBs within different regions of these countries. There also existed significant variations in HRBs regarding age, education, employment status, wealth index, household size, place of residence, and region of residence in the three countries. In the contextual models of environmental and social factors, population density significantly increased odds of HRBs in the three countries, maximum temperature significantly increased odds of HRBs in Benin and Mali, while precipitation significantly increased odds of HRBs in Nigeria and Mali. Other factors which significantly increased odds of HRBs across the three countries were increase in age, wealth index, households with 9+ persons, and regions of residence. Conclusions These findings suggest that among other things, changes in lifestyles regarding the different HRBs should be emphasized in specific contextual situations Key messages • There are variations in engagement in health risk behaviours across the countries. • Cliamte variables influence engagement in health risk behaviours.