Body Mapping as Risk Factors for Non-Communicable Diseases in Ghana: Evidence from Ghana’s 2023 Nationwide STEPS Survey

Noncommunicable diseases (NCDs) are the leading cause of global morbidity and mor-tality, accounting for over 43 million deaths in 2021, with 18 million occurring in indi-viduals under 70 years. Low- and middle-income countries (LMICs) bear the brunt, with over 80% of premature deaths attributed to NCDs, primarily cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. Beyond health impacts, NCDs drive significant economic losses, estimated at $7 trillion between 2011 and 2025, while preven-tion costs are far lower. This secondary analysis of a national survey explores how body mapping measures such as BMI, waist circumference, and waist-to-hip ratio can predict the risk of major NCDs, including hypertension, diabetes, and heart diseases. The Ghana STEPS survey employed a cross-sectional design to assess noncommunicable disease (NCD) risk factors nationwide using the WHO STEPwise approach, incorporating demographic and behavioral data collection (Step 1), physical measurements (Step 2), and biochemical assessments (Step 3). A nationally representative sample of 5,775 partici-pants was selected using multistage stratified sampling, ensuring proportional represen-tation by region, urban/rural residency, age, and gender. Ethical approval was obtained, and informed consent was secured from participants. Anthropometric and biochemical data were collected following standardized protocols, including measurements of height, weight, waist and hip circumferences, blood pressure, fasting glucose, and lipid profiles. Data were analyzed using STATA 17.0, accounting for complex survey design with ap-propriate weighting. The study found significant sex-based differences in anthropometric measures, with men being taller and lighter while women had higher waist and hip circumferences and BMI. The prevalence of NCDs increased with age, highest in participants aged 60–69 years, and was more common in females than males. Lower educational attainment and marital status (widowed, divorced, or separated) were associated with higher NCD prevalence, while obesity and very high waist circumference were the strongest predictors of NCD risk. ROC analysis of anthropometric measures showed fair predictive ability, with waist circumference, BMI, and waist-to-hip ratio showing similar modest performance in iden-tifying individuals with at least one NCD. Anthropometric measures such as waist circumference, hip circumference, BMI, waist-to-hip ratio, and waist-to-height ratio are strongly associated with the risk of major noncommunicable diseases (NCDs) like hypertension, diabetes, dyslipidemia, and cardi-ovascular events. However, individually, these measures lack sufficient accuracy for effec-tive screening. Integrated screening approaches combining multiple risk factors, along with tailored interventions, should be implemented to improve early detection and man-agement of NCDs, particularly in resource-limited settings.