Living in an urban environment and non-communicable disease risk in Thailand: Does timing matter?

BACKGROUND: This paper uses a life-course approach to explore whether the timing and/or duration of urban (vs rural) exposure was associated with risk factors for NCDs. METHODS: A cross-sectional survey was conducted among health care workers in two hospitals in Thailand. Two measures of urbanicity were considered: early-life urban exposure and the proportion of urban life years. We explored four behavioral NCD risk factors, two physiological risk factors and four biological risk factors. RESULTS: Both measures of urbanicity were each independently associated with increases in all behavioral and physiological risk factors. For some biological risk factors, people spending their early life in an urban area may be more susceptible to the effect of increasing proportion of urban life years than those growing up in rural areas. CONCLUSION: Urbanicity was associated with increases in behavioral and physiological risk factors. However, these associations may not translate directly into increases in biological risk factors. It is likely that these biological risk factors were results of a complex interaction between both long term accumulation of exposure and early life exposures.