Prevalence and risk factors of cardiometabolic disease among informal sector workers in Cape Coast, Ghana: Insights from the CarMeR study
4 affiliations
- 1Department of Health, Physical Education and Recreation, University of Cape Coast, Cape Coast, Ghana
- 2Cardiometabolic Epidemiology Research Laboratory, University of Cape Coast, Cape Coast, Ghana
- 3Department of Labour and Human Resource Studies, University of Cape Coast, Ghana
- 4Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
Abstract
Background: The prevalence of cardiometabolic diseases like obesity, hypertension, diabetes, and dyslipidaemia is increasing rapidly, particularly in low- and middle-income countries (LMICs). Informal workers in Ghana, who account for the majority of the national workforce, contribute significantly to the country’s socioeconomic growth. Often, their work predisposes them to cardiometabolic diseases. This study examines the cardiometabolic burden, its associated factors, and the diagnostic heterogeneity among this unique population. Methods: This study used cross-sectional data on 948 informal workers (traders, fisherfolk, artisans, farmers, and drivers) in the Cape Coast Metropolis, Ghana. Sociodemographic, lifestyle, anthropometric, and biochemical data were obtained in accordance with standard procedures. Multiple diagnostic criteria were used to characterise diabetes, prediabetes, and obesity. Diagnostic concordance was evaluated using Venn diagrams and UpSet plots, and independent associated factors were identified using multivariate logistic regression. Results: The prevalence of obesity, hypertension, prediabetes, and diabetes was 45.46%, 40.19%, 29.54%, and 13.40%, respectively. Women and middle-aged adults (45–59 years) were most impacted. There was significant heterogeneity in classification criteria, with just 9.28% of obese participants and 2.36% of diabetic participants being diagnosed by all diagnostic criteria. While the absence of childhood obesity was associated with lower odds of obesity (aOR = 0.43, 95% CI: 0.30–0.61), diabetes (aOR = 0.64, 95% CI: 0.42–0.99), and hypertension (aOR = 0.63, 95% CI: 0.46–0.88), older age (≥60 years) was strongly associated with obesity (aOR = 2.54, 95% CI: 1.51–4.32) and hypertension (aOR = 4.82, 95% CI: 3.06–7.68). Low physical activity was significantly linked to hypertension (aOR = 1.73, 95% CI: 1.16–2.62), and elevated triglycerides were associated with diabetes (aOR = 2.16, 95% CI: 1.21–3.75) and hypertension (aOR = 1.84, 95% CI: 1.13–3.04). Conclusions: The burden of cardiometabolic diseases among Ghana’s informal workers is disproportionately high and diagnostically diverse. The findings emphasise the critical need for sex- and occupation-sensitive health interventions, life-course prevention strategies, and context-specific diagnostic guidelines to reduce cardiometabolic disease risk among informal workers in LMICs.
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BibTeX
@article{hormenu2026prevalence,
title = {{Prevalence and risk factors of cardiometabolic disease among informal sector workers in Cape Coast, Ghana: Insights from the CarMeR study}},
author = {Thomas Hormenu and Ebenezer Oduro Antiri and Eric Awlime-Ableh and Juliet Elikem Paku and Edward Edem Nartey and Shaibu Bukari and Adeladza Kofi Amegah},
journal = {PLOS One},
year = {2026},
month = sep,
doi = {10.1371/journal.pone.0359530},
url = {https://doi.org/10.1371/journal.pone.0359530},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Prevalence and risk factors of cardiometabolic disease among informal sector workers in Cape Coast, Ghana: Insights from the CarMeR study
AU - Thomas Hormenu
AU - Ebenezer Oduro Antiri
AU - Eric Awlime-Ableh
AU - Juliet Elikem Paku
AU - Edward Edem Nartey
AU - Shaibu Bukari
AU - Adeladza Kofi Amegah
PY - 2026
DA - 2026/09/29
JO - PLOS One
DO - 10.1371/journal.pone.0359530
UR - https://doi.org/10.1371/journal.pone.0359530
AB - Background: The prevalence of cardiometabolic diseases like obesity, hypertension, diabetes, and dyslipidaemia is increasing rapidly, particularly in low- and middle-income countries (LMICs). Informal workers in Ghana, who account for the majority of the national workforce, contribute significantly to the country’s socioeconomic growth. Often, their work predisposes them to cardiometabolic diseases. This study examines the cardiometabolic burden, its associated factors, and the diagnostic heterogeneity among this unique population. Methods: This study used cross-sectional data on 948 informal workers (traders, fisherfolk, artisans, farmers, and drivers) in the Cape Coast Metropolis, Ghana. Sociodemographic, lifestyle, anthropometric, and biochemical data were obtained in accordance with standard procedures. Multiple diagnostic criteria were used to characterise diabetes, prediabetes, and obesity. Diagnostic concordance was evaluated using Venn diagrams and UpSet plots, and independent associated factors were identified using multivariate logistic regression. Results: The prevalence of obesity, hypertension, prediabetes, and diabetes was 45.46%, 40.19%, 29.54%, and 13.40%, respectively. Women and middle-aged adults (45–59 years) were most impacted. There was significant heterogeneity in classification criteria, with just 9.28% of obese participants and 2.36% of diabetic participants being diagnosed by all diagnostic criteria. While the absence of childhood obesity was associated with lower odds of obesity (aOR = 0.43, 95% CI: 0.30–0.61), diabetes (aOR = 0.64, 95% CI: 0.42–0.99), and hypertension (aOR = 0.63, 95% CI: 0.46–0.88), older age (≥60 years) was strongly associated with obesity (aOR = 2.54, 95% CI: 1.51–4.32) and hypertension (aOR = 4.82, 95% CI: 3.06–7.68). Low physical activity was significantly linked to hypertension (aOR = 1.73, 95% CI: 1.16–2.62), and elevated triglycerides were associated with diabetes (aOR = 2.16, 95% CI: 1.21–3.75) and hypertension (aOR = 1.84, 95% CI: 1.13–3.04). Conclusions: The burden of cardiometabolic diseases among Ghana’s informal workers is disproportionately high and diagnostically diverse. The findings emphasise the critical need for sex- and occupation-sensitive health interventions, life-course prevention strategies, and context-specific diagnostic guidelines to reduce cardiometabolic disease risk among informal workers in LMICs.
SN - 1932-6203
ER -