Urban, Semi-Urban and Rural Disparities in Health State Valuation among Nigerian Adults: Implications for Sustainable Health Equity and Development Goals
1
Clinical Pharmacy and Pharmacy Management, Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
2
Department of Health Administration and Management, Health Policy Research Group, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A1221
ABSTRACT
INTRODUCTION:
Achieving health equity is a cornerstone of the Sustainable Development Goals (SDG 3) and the Universal Health Coverage (UHC) agenda. However, persistent disparities across urban, semi-urban, and rural areas in Nigeria pose a threat to achieving sustainable health equity. Rapid urbanization, coupled with socioeconomic inequalities, influences how adults perceive and value their health, reflecting broader inequities in the social determinants of health. This study assessed how geographical location influences self-reported health and the valuation of health states among Nigerian adults, providing insights for context-sensitive health equity strategies.
METHODS:
The cross-sectional survey was conducted among 2700 adults selected through multistage sampling from six states representing Nigeria’s six geopolitical zones. Health-related quality of life was assessed using the EQ-5D-Y-3L descriptive system and the EQ-VAS, following the EQ-VT protocol. Descriptive statistics, Kruskal–Wallis tests, Pearson correlations, and multivariate logistic regression models were used to explore associations between geographical location, sociodemographic factors, and health valuations at a 95% confidence level.
RESULTS:
Respondents in semi-urban locations reported the highest mean EQ-VAS scores (82.6 ± 12.2), followed by rural (82.1 ± 13.0) and urban areas (81.8 ± 13.7; p = 0.017). Urban residents reported higher levels of pain/discomfort (35.5%) and emotional distress (36.0%) and exhibited the highest overall severity index of health states (5.91 ± 1.13). Employment, educational attainment, and income were significantly associated with both health valuation and location (p < 0.05).
CONCLUSIONS:
Health disparities across urban, semi-urban, and rural Nigeria underscore the complex interplay between location and social determinants of health. Urbanization, while offering economic and infrastructural advantages, may also intensify or reproduce psychosocial and environmental stressors that undermine well-being. To advance SDG 3 and UHC in Nigeria, policymakers must adopt regionally responsive health strategies that promote equitable access to care, strengthen mental health services, and address socioeconomic vulnerabilities across all geographical locations
Achieving health equity is a cornerstone of the Sustainable Development Goals (SDG 3) and the Universal Health Coverage (UHC) agenda. However, persistent disparities across urban, semi-urban, and rural areas in Nigeria pose a threat to achieving sustainable health equity. Rapid urbanization, coupled with socioeconomic inequalities, influences how adults perceive and value their health, reflecting broader inequities in the social determinants of health. This study assessed how geographical location influences self-reported health and the valuation of health states among Nigerian adults, providing insights for context-sensitive health equity strategies.
METHODS:
The cross-sectional survey was conducted among 2700 adults selected through multistage sampling from six states representing Nigeria’s six geopolitical zones. Health-related quality of life was assessed using the EQ-5D-Y-3L descriptive system and the EQ-VAS, following the EQ-VT protocol. Descriptive statistics, Kruskal–Wallis tests, Pearson correlations, and multivariate logistic regression models were used to explore associations between geographical location, sociodemographic factors, and health valuations at a 95% confidence level.
RESULTS:
Respondents in semi-urban locations reported the highest mean EQ-VAS scores (82.6 ± 12.2), followed by rural (82.1 ± 13.0) and urban areas (81.8 ± 13.7; p = 0.017). Urban residents reported higher levels of pain/discomfort (35.5%) and emotional distress (36.0%) and exhibited the highest overall severity index of health states (5.91 ± 1.13). Employment, educational attainment, and income were significantly associated with both health valuation and location (p < 0.05).
CONCLUSIONS:
Health disparities across urban, semi-urban, and rural Nigeria underscore the complex interplay between location and social determinants of health. Urbanization, while offering economic and infrastructural advantages, may also intensify or reproduce psychosocial and environmental stressors that undermine well-being. To advance SDG 3 and UHC in Nigeria, policymakers must adopt regionally responsive health strategies that promote equitable access to care, strengthen mental health services, and address socioeconomic vulnerabilities across all geographical locations
| eISSN: | 2654-1459 |
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