KNOWLEDGE, ATTITUDE AND PERCEPTION WITH REGARDS TO PREVENTION OF HYPERTENSION AMONG BANKERS IN MUSHIN LOCAL GOVERNMENT AREA, LAGOS, NIGERIA

CHAPTER ONE

INTRODUCTION

1.1       Background to the Study

Globally, hypertension is the third leading risk factor contributing to mortality and morbidity rate, and this is over powered only by malnutrition and smoking.The African continent is undergoing a double burden of disease, with Hypertension among the leading cause of non- communicable disease (WHO, 2012). The African region has the highest prevalence rate of hypertension with the estimate of 46% (WHO, 2013). Hypertension is said to be responsible for 45% of death due to heart disease and 51% of death due to stroke worldwide, and billions of people being affected globally (Addo, Smeeth & Leon, 2007; Kearney, Whelton, Reynolds, Muntner & Whelton, 2004; WHO, 2013).  In Nigeria, Hypertension is the most common cardiovascular disease reported, with the death rate of 13.62% per 100,000 population as at 2014 (Ogah, Madukwe, Chukwuonyi, Onyeonoro, Ukegbe &Akhimien, 2013; WHO 2014).

Sedentary lifestyle is one of the major risk factors of hypertension (Henson, Yates, Biddle, Edwardson & Khunti, 2013). Thus sedentary lifestyle can be seen as a social problem that requires attention. Jobs that require mostly sitting is high and occupations have become more sedentary and less physically active over the past few decades (Chau, van der Ploeg, Merom, Chey & Bauman, 2012; Vhurch, Thomas, Tudor-Locke, Katzmarzyk, Earnest, Rodarte et al., 2011). The occupations that are most at risk of prolonged sitting include office work, transportation, white collar jobs and highly mechanized trades (Owen, Healy, Mathew & Dunstan, 2010). Bankers in the banking halls  spend almost all  day sitting, which  include their customer service, cashiers, office assistance, and other members of staff (Jogunola & Awoyemi, 2010), people in these occupations typically spend a great deal of the working day sitting down. In a normal 16-hour day, it’s easily possible to spend over 80% of the time seated.

The increase in physical inactivity worldwide is considered by World Health Organization (WHO) to be an epidemic in both the developing and developed countries, with physical inactivity estimated to account for 6% of global deaths (WHO, 2009).  The WHO’s 2004 Global Strategy on Diet, Physical Activity and Health highlights the workplace as an important setting for health promotion stating that “Workplaces are important settings forhealth promotion and disease prevention…” Also, was the WHO’s Global Plan of Action on Worker’s Health 2008-2017, which specified that “Health promotion and prevention of non-communicable diseases should be further stimulated in the workplace, in particular by advocating healthy diet and physical activity among workers …”.  Promoting health in the workplace increases the chances of health and well-being focused on promoting worker health through reduction of individual risk-related behaviors such as a sedentary lifestyle (LeMontagne, 2004; Marshall, 2004; O’Donnell, 2002).

Only 9% of public sector bankers perform gym activity regularly (Naqvi, Zehra & Nizami, 2013).  Evidence shows that sedentary behavior is associated with greater waist-to-hip ratio, increased risk of low back pain, cancer, metabolic syndrome and all-cause and CVD mortality, cardiac complications, increased risk for certain cancers, early mortality, type2 diabetes, cardiovascular disease, and mortality (Proper, 2011; Roffey, 2010; Schmid & Leitzmann, 2014; Sisson, 2009; Thorp, Owen, Neuhaus & Dunstan, 2011; Wilmot, Edwardson, Achana, Davies, Gorely, Gray et al.,2012; Van Uffelen, 2010). There is a 15% increased risk of death in the next three years if you sit for 8-11 hours per day, when compared to those who sit for less than four hours per day. This risk increases to 40% for those who sit for greater than 11 hours per day (Parry & Straker, 2013; Smith, Hamer, Ucci, Marmot, Gardner, Sawyer et al.,2015; Van der Ploeg, Chey, Korda, Banks & Bauman, 2012).

With this in mind, sedentary behaviour is now being considered as a potential work health and safety issue (Straker, Coenen, Dunstan, Gilson & Healy, 2016) It has been established that 150 minutes of at least moderate intensity aerobic physical activity throughout the week to reduce the risk of chronic disease, albeit even when individuals engage in 150 min per week of physical activity, studies suggest that what happens in the remaining approximately 6500 minutes of the waking week is important for health (WHO, 2010). The longer the time spent sitting down each day, the higher the risk of dying prematurely, even if regular daily exercise is performed showing that the increase risk of mortality from time spent sitting appears to be independent of physical activity level (Hamilton, Genevieve, Dunstat, Zderic & Owen, 2008; Patel, 2010).

1.2       Statement of the Problem

It has been revealed that 30 minutes of physical activity or 10,000 steps per day produces significant clinical health benefits to an individual’s health, however, those in sedentary occupations are more likely to not meet the minimum requirements to experience the health benefits associated with physical activity (Le Masurier, Sidman, & Corbin, 2003) predisposing them to developing hypertension or other diseases due to sedentary lifestyle. It has been established that there is a high prevalence of sedentary lifestyle among bankers (Jogunola & Awoyemi, 2010) putting them at high level of susceptibility to hypertension and other cardiovascular diseases established to be as a result of sedentary lifestyle and most especially prolonged sitting (Proper, 2011; Roffey, 2010; Sisson, 2009; Thorp et al., 2011; Wilmot et al., 2012; Van Uffelen, 2010). However, there are no documented efforts at reducing these behaviors among the bankers. Workplace Health Promotion has over been under explored especially in combating sedentary lifestyle and promoting physical activities. From literature reviewed, it is evident that there are no studies that have comprehensively assessed the knowledge, attitude and perception of bankers to sedentary lifestyle and the availability of workplace health promotion promoting physical activities in Nigerian banks.