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Cities across the globe are prioritizing resilience in the wake of increasing climate change-related disasters. About 44% of these disasters are floods and their manifestation in cities is more pronounced, threatening urban social, ecological, and economic systems. This study draws on community resilience and participatory GIS, to examine land use vulnerability to flooding and local coping and adaptive strategies to achieve resilience. Using Ghana as a case study, the results show that participatory mapping offers community resilience benefits by providing context to community resilience challenges and potentials, enabling a deeper understanding of socio-environmental coupling that contributes to flood vulnerability and builds on community adaptive strategies through harnessing local community knowledge. We identified that topography, poor drainage and road network, rainfall variability, residents' land use practices, and land use planning conundrum drive disparities in land use vulnerability to flooding. Participants underscored the necessity of critical urban infrastructure in facilitating community adaptability to floods. The findings indicate that socio-spatial inequities threaten urban community resilience, especially in increasingly cosmopolitan urban contexts, by putting the marginalized urban population in a more vulnerable position. We recommend the prioritization of recognitional equity in community resilience planning efforts to allow for the targeting of resilient interventions that reflect and respect social differentiation in the urban environment so that outcomes will not exacerbate or generate new urban socio-spatial inequalities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Vaccine hesitancy is considered one of the ten threats to global health. In the context of the COVID-19 pandemic, vaccine hesitancy may undermine efforts toward controlling or preventing the disease. Nevertheless, limited research has examined vaccine hesitance, particularly in low- and middle-income countries (LMICs). It is thus imperative to examine how institutional trust and conspiracy belief in tandem influence the uptake of COVID-19 vaccines. Using data (n = 2059) from a cross-sectional study in Ghana, this study examines the association between institutional trust, conspiracy beliefs, and vaccine uptake among adults in Ghana using logistics regression. The regression model (model 3) adjusted for variables such as marital status, age, gender, employment, income, and political affiliations. The results show that individuals were significantly less likely to be vaccinated if they did not trust institutions (OR = .421, CI = .232-.531). Similarly, we found that individuals who believed in conspiracy theories surrounding the COVID-19 vaccine were less likely to be vaccinated (OR = .734, CI = .436-.867). We also found that not having a COVID-19-related symptom is associated with vaccine refusal (OR = .069, CI = .008-.618). Similarly, compared to those with a vaccine history, those without a vaccine history are less likely to accept the COVID-19 vaccine (OR = .286, CI = .108-.756). In conclusion, our results demonstrate the need for enhanced education to tackle conspiracy beliefs about the disease and enhance vaccine uptake. Given the role of trust in effecting attitudinal change, building trust and credibility among the institutions responsible for vaccinations ought to be prioritized., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Achore et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Monkeypox (MPOX) was declared a global public health emergency of international concern in July 2022. Vaccinations may be an essential strategy to prevent MPOX infections and reduce their impact on populations, especially among at-risk populations. However, less is known about the factors associated with people's willingness to accept the MPOX vaccine in resource-constrained settings. In this study, we examine the associations between self-rated health, previous vaccine uptake, and people's willingness to accept the MPOX vaccine using cross-sectional data from four major cities in Ghana. The data were analyzed using descriptive and logistic regression techniques. We found that the acceptance of the MPOX vaccine is generally low (approximately 32%) in Ghana. The regression analysis reveals that individuals who did not receive vaccines in the past are much less likely to get the MPOX vaccine (AOR:.28; 95% CI:.62-2.37). The association between self-rated health and vaccine acceptance (AOR: 1.22; 95% CI:.62-2.37) disappeared after we accounted for covariates. Based on these findings, we conclude that vaccine uptake history may be critical to people's uptake of the MPOX vaccine., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Braimah et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

The main goal of this study was to examine the relationship between exposure to mass media health campaign massages and the uptake of non-communicable diseases (NCDs) screening services in Ghana and whether this relationship differs by place of residence. Available evidence suggests a general low uptake of NCDs screening in developing country settings. Unfortunately, many NCDs evolve very slowly and are consequently difficult to detect early especially in situations where people do not screen regularly and in settings where awareness is low. In this study, we contribute to understanding the potential role of the media in scaling up NCDs screening in developing countries. We fitted multivariate logistic regression models to a sample of 1337 individual surveys which were collected at the neighborhood level in three Ghanaian cities. Overall, the results show that exposure to mass media chronic NCD health campaign messages was significantly associated with increased likelihood of screening for NCDs. The results further highlight neighborhood-level disparities in the uptake of NCDs screening services as residents of low-income and deprived neighborhoods were significantly less likely to report being screened for NCDs. Other factors including social capital, knowledge about the causes of NCDs and self-rated health predicted the likelihood of chronic NCDs screening. The results demonstrate mass media can be an important tool for scaling up NCDs screening services in Ghana and similar contexts where awareness might be low. However, place-based disparities need to be addressed., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Konkor et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Global health surveillance reports show Africa's epidemiologic transition from one dominated by higher burdens of nutritional, maternal, and communicable diseases to one increasingly dominated by non-communicable diseases (NCDs). Debates on the increasing cases of NCDs in the African context have focused on individualistic risk factors to the neglect of other similar important determinants such as the living environment. Drawing on theoretical tenets of the protection motivation theory and using cross-sectional data, we examined neighborhood risk perceptions and self-rated risk of developing NCDs in Ghana. The dependent variable 'self-rated risk of developing NCDs' was measured as a binary outcome and the focal independent variable - perceived neighborhood health risk - as an index. We fitted multivariate multilevel regression models to a sample of 1376 individuals across 9 neighborhoods. Results show that respondents who perceived their neighborhoods as risky were more likely to rate their risk of developing NCDs high. A unit increase in neighborhood violence was associated with 8% likelihood of self-rated risk of developing NCDs. However, a unit increase in the aesthetic quality of respondent's neighborhood was associated with lower likelihood of self-rated risk of developing NCDs. Engaging in regular physical activity, and non-tobacco use were associated with a lower likelihood of perceived NCDs risk. We suggest policy agendas intended for reducing the burden of NCDs in Ghana and other LMICs could incorporate programs that target improving environmental characteristics to minimize risks and offer people the opportunity to make healthy choices., Competing Interests: Declaration of competing interest None., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objective: Canada became a preferred destination for many non-European and non-American migrants since the introduction of favorable immigration policies in the late 1960 s. Blackimmigrants from the African and Caribbean regions however are a known vulnerable population to HIV infection in Canada. Even though first-generation immigrants might differ from subsequent generations in terms of culture and beliefs which are important for health outcomes and behaviors, research examining disparities in their use of preventative healthcare is limited. This study aimed to examine generational disparities in the uptake of HIV screening services among a sample of heterosexual Black men in Ontario, Canada., Methods: We used data from a cross-sectional survey sample ( n  = 829) that was collected from heterosexual Black men in four Ontarian cities (Toronto, Ottawa, London and Windsor) between March 2018 and February 2019. We used the negative log-log link function of the binomial family to examine the independent relationship between immigration status and the uptake of HIV testing and the cumulative effect of other predictor variables on HIV testing in nested models., Results: Findings from multivariate analysis show second-generation immigrants were significantly less likely to test for HIV compared with their first-generation immigrant counterparts. After controlling for theoretically relevant variables, the second-generation immigrants were 53% less likely to test for HIV. We further observed that participants with good knowledge of HIV transmission (OR=1.05; p  > 0.05) and those who were older were more likely to test for HIV. Those with masculine tendencies (OR=0.98; p  > 0.05) and those who reported not having sexual partner were less likely to test (OR=0.57; p  > 0.01). Religion emerged as a significant predictor of HIV testing as Christians (OR=1.62; p  > 0.05) and other believers (OR=1.59; p  > 0.05) were more likely to test for HIV when compared to their Muslim counterparts., Conclusion: HIV prevention policies may need not only prioritize first-generation immigrants, but the wellbeing of their descendants as well. This could be achieved by implementing programs that will enhance second-generation immigrants' use of HIV screening services. Additionally, HIV educational programs would be of relevance and especially so as respondents with good knowledge of HIV transmission consistently demonstrated higher likelihood of testing for their HIV status., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2022 The Author(s). Published by Elsevier Ltd.)

The employment landscape has changed significantly over the past few years in emerging economies including Ghana where many people are rapidly transitioning from livelihood activities that originally involved physical exertion to work environments where performance of duties are mostly non-physical. Working under non-active conditions could, however, exacerbate the risk of developing chronic diseases that are increasingly becoming problematic in many developing countries. Drawing on a cross-sectional nationally representative sample data of 4425 adult Ghanaian workers collected by the WHO Study on Global Ageing and Adult Health in developing countries, we examined the relationship between occupational physical activity and hypertensive status. We employed the complementary log-log analysis technique to build nested models with results presented in odds ratios. After controlling for several relevant variables, the results show that performing sedentary related work (AOR = 1.23, CI = 1.06-1.42) is significantly associated with a higher likelihood of being hypertensive compared with those whose work involved moderate physical activity. Other factors that were significantly associated with being hypertensive included tobacco use (AOR = 1.33, CI = 1.05-1.70), living in an urban environment (AOR = 1.15, CI = 1.01-1.32), and being a female (AOR = 1.18, CI = 1.01-1.37) and being an older person. Policies on reducing the risk of developing chronic conditions especially hypertension need to recognize the contributions of the work environment in emerging developing economies., (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Occupational Hygiene Society.)

Like most countries in sub-Saharan Africa, hypertension contributes substantially to morbidity and mortality in Ghana, yet nationally representative studies that examine the odds of becoming hypertensive among Ghanaians are conspicuously missing. We aimed to fill this void in the literature. The data used for analysis came from the first wave of the Study on Global Ageing and Adult Health (SAGE), collected in Ghana from January 2007 to December 2008 by the World Health Organization (WHO). A total of 5573 respondents were sampled for the study. Random-effects C-log-log models were employed in examining socio-economic, lifestyle and psychosocial factors on the odds of becoming hypertensive in Ghana. Separate models were run for male and females. Results indicated there were strong significant associations between socio-economic, lifestyle and psychosocial factors on the likelihood of becoming hypertensive, among Ghanaian men and women. Compared with the poorest, Ghanaians from wealthy households were significantly more likely to be hypertensive. Educated women, as compared with the uneducated, were also more likely to be hypertensive. Ghanaians who engaged in vigorous or intensive activities continuously, for at least 10 minutes, were significantly less likely to be hypertensive, compared to those who did not. Happier men had lower odds of becoming hypertensive, and depressed women had increased odds of reporting they were hypertensive.

Several studies indicate little congruence between self-report and biometric data, yet very few have examined the reasons for such differences. This paper contributes to the limited but growing body of literature that tracks inconsistent reports of hypertension using data from the Study on Global Ageing and Adult Health (SAGE). Focusing on five countries with different levels of development (Ghana, China, India, South Africa, and Russia), this study offers a comparative perspective that is missing in the literature. Data were obtained from wave 1 of SAGE collected in 2007/2008. A multinomial logit model was used to examine the effects of demographic and socioeconomic variables on the likelihood of respondents self-reporting that they are not hypertensive when their biometric data show otherwise. The authors also model the likelihood of respondents self-reporting that they are hypertensive when in fact their biometric data show they are not. Socioeconomic and demographic variables were shown to be significantly associated with inconsistent reporting of hypertension. For instance, it was observed that wealth was associated with a lower likelihood of self-reporting that one is not hypertensive when their biometric data indicate otherwise. Tracking such inconsistent reports is crucial to minimizing measurement errors and generating unbiased and more precise parameter estimates in hypertension research., (© 2015 Wiley Periodicals, Inc.)

Negotiating safer sex among married women has been identified as an important determinant of vulnerability or resilience to new HIV infections. Using the Cambodia Demographic and Health Survey data of 2010, this paper examined negotiation for safer sex among 11,218 married women in the context of Cambodia's highly touted reduction in HIV/AIDS prevalence. The results from a complementary log-log regression model indicate that wealthier and highly educated married women were more likely to report that they can refuse sexual intercourse and ask their husbands to use a condom. Interestingly, while women who were fully involved in decision-making on their own health care were 19% more likely to refuse sex, they were 14% less likely to be able to ask their husbands to use a condom, compared with their counterparts who were not involved in this decision-making. Women who were partially involved in decision-making on family visits were 17% less likely to be able to ask their husbands to use a condom compared with those who were not involved. In this context, involvement in decision-making may have translated into trust and risk compensation. Those who believed in HIV transmission myths were less likely to negotiate safer sex relative to their counterparts who did not hold such myths to be true. Women's ability to negotiate for safer sex is, therefore, a function of their autonomy in terms of their full participation in decision-making in health care, household expenditure and mobility. Policy implications of the capacity of women to negotiate for safer sex are delineated.