Environmental health knowledge, healthy lifestyles and better environmental living conditions among slum dwellers in Dhaka

Introduction: Millions of slum dwellers in cities suffer from higher burden of diseases partly because of stressful environmental living conditions (ELC), poor socio-economic status and lifestyles. We assessed the association of environmental health knowledge (EHK) with healthy lifestyles and ELC among adults (n=1,937) living in nine big slums of Dhaka megacity, assuming that better EHK is associated with healthy lifestyles and better ELC. Methods: The baseline information from a recent cohort study was used. Background: characteristics e.g. area, age, education, and migration including a composite variable (based on three EHK-related questions, one is explained) of EHK were used as covariates. One EHK-related question was „Do you think that logged/polluted water surrounding your house spreads diseases or increases health risk (yes/no)?“ When they answered yes, they were asked why (open-ended answers)? Some answered correctly (coded, yes=1) and some not (no=0). Scores of the composite variable, ranging from 0–3, were dichotomised, where scores=2–3 indicated „better EHK“. SPSS 17.0 was used for analyses. Although many dependent variables reflecting lifestyles and ELC were analysed, only few results are reported here. Results: About 80% of the total sample reported better EHK, which significantly differed by study area and education. According to multivariable logistic regression analysis, odds ratios (ORs) for cigarette smoking (OR=0.72, p=0.037), smoking inside home (OR=0.70, p=0.040) and not purchasing bottle water for drinking while staying outside home (OR=0.28, p<0.001) were significantly lower among people having better EHK. Similarly ORs for ELC-related variables namely „garbage was collected regularly in their areas“ (OR=1.39, p=0.009) and „living in a house getting sufficient light and air“ (OR=1.31, p=0.056) were higher among people having better EHK. Conclusion: Evidence suggests that better EHK in slum dwellers is positively associated with healthy lifestyles and better ELC. Therefore we recommend to improve area-specific EHK by emphasising e.g. better education.