Evidence map›Paper›PMID 41088189›Full record

ArticleBMC public health2025

Community perspectives on the built environment, community stress, and the risk of diabetes and cardiovascular diseases in Accra, Ghana.

Mawuli Komla Kushitor, Haim Yacobi, Lydia Osetohamhen Okoibhole, Sandra Batemaa Kushitor, Publa Antwi, Irene Akwo Kretchy, Olutobi Adekunle Sanuade, Samuel Amon, Leonard Baatiema, Vida Asah-Ayeh and 7 more

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Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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17 authors.

Mawuli Komla KushitorDepartment of Health Policy, Planning and Management (HPPM), Fred N. Binka School of Public Health (HPPM), University of Health and Allied Sciences (UHAS), Ho, Volta Region, Ghana. mkushitor@uhas.edu.gh.
Haim YacobiDevelopment Planning Unit, Faculty of the Built Environment, University College London, London, UK.
Lydia Osetohamhen OkoibholeFaculty of Education, University of Cambridge, Cambridge, UK.
Sandra Batemaa KushitorDepartment of Community Health, Ensign Global College, Kpong, Ghana.
Publa AntwiDepartment of Health Sciences, University of York, York, UK.
Irene Akwo KretchyDepartment of Pharmacy Practice and Clinical Pharmacy, School of Pharmacy, University of Ghana, Legon, Ghana.
Olutobi Adekunle SanuadeDepartment of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, USA.
Samuel AmonDepartment of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Ghana.
Leonard BaatiemaDepartment of Health Policy, Planning and Management, School of Public Health, University of Ghana, Legon, Ghana.
Vida Asah-AyehUniversity of Ghana, Legon, Ghana.
Hassan Haghparast-BidgoliInstitute for Global Health, University College London, London, UK.
Hannah Maria JenningsDepartment of Health Sciences, University of York, York, UK.
Daniel Llywelyn StrachanThe Nossal Institute for Global Health, University of Melbourne, Melbourne, Australia.
Carlos Salvador Grijalva-EternodInstitute for Global Health, University College London, London, UK.
Ann BlandfordDepartment of Computer Science, University College London, London, UK.
Megan VaughanInstitute of Advanced Studies, University College London, London, UK.
Edward FottrellInstitute for Global Health, University College London, London, UK.

Funding

UK Research and Innovation MR/T029919/1
6 · The paper itself

Abstract

backgroundThe growing burden of diabetes and other non-communicable diseases in Africa demands greater understanding of the contextual drivers of risk factors, including the built environment. Cognitive Mapping (CM) is a participatory research approach that allows community members to visualise their environmental context through drawing. The maps express in visual form the situated knowledge of the environment from local perceptions of daily experiences. This study combines Geographic Information System (GIS) techniques and qualitative research methods to explore community perspectives on the environmental risk factors of diabetes and other cardiovascular diseases (CVDs) in a poor urban community in Accra, Ghana.

methodsFive Cognitive Map Focus Group Discussions (CM-FGDs) and four regular Focus Group Discussions (FGDs) were conducted with a total of 43 participants in Ga Mashie (Accra) in November and December 2022. Participants (25 women and 18 men) had lived in the study communities for over ten years. Community members were given paper and a pencil for the CM sessions to draw their environment. GIS maps supplemented the community drawings. We adopted geo-ethnography, a technique that combines GIS and qualitative analytical methods. The GIS was used to recreate aspects of the physical environment discussed by study participants. The FGDs were analysed thematically.

resultsParticipants recognised the physical and social attributes of their daily environment and how these attributes influence the risk of CVDs. Excessive heat and hazardous noise from overcrowded spaces emerged as key health risks. The social environment was equally important – participants often linked the high concentration of bars, spaces for social interaction and several social engagements at weekends to excessive consumption of alcohol and unhealthy food. Community members reported that social behaviour and diet associated with their environments were gradually deteriorating, and these accounted for observed changes in patterns of diabetes and related CVDs. Specifically, community members attributed the causes of hypertension and heart disease to hazardous noise and psychological distress associated with the built environment. In contrast, diabetes was generally attributed to the social environment.

conclusionCognitive maps allowed community members to participate in research and link the risk of diabetes and CVDs to their changing environment. Built environment interventions should empower communities to make large-scale behavioural modifications to improve the prevention and control of diabetes and CVDs within their community.

Indexed as

Built EnvironmentCardiovascular DiseasesDiabetes MellitusResidence CharacteristicsStress, PsychologicalAdultCommunity-Based Participatory ResearchFemaleFocus GroupsGeographic Information SystemsGhanaHumansMaleMiddle AgedQualitative ResearchRisk FactorsBuilt environmentCardiovascular diseasesCognitive mapCommunity perspectivesDiabetesStress

Identifiers

PMID41088189
PMCPMC12522272

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.