Coping disability of Africans during urbanization: a risk marker in the development of lifestyle diseases?

Abstract

Urbanization with accompanying insecurities and disruption in African social relationships is consistent with an increase in the prevalence of lifestyle diseases such as hypertension and the metabolic syndrome. The individual with less positive social relationships like those experienced during urbanization will perceive this interaction as being particularly stressful. If lifestyle factors (smoking habits, alcohol consumption, physical inactivity) additionally are added to their inherently higher levels of salt sensitivity, lower levels of plasma renin activity and vascular hyperreactivity, the prevalence of hypertension in Africans is more understandable. How Africans cope with urbanization though has not been well described and it is not certain how a particular coping style may be associated with factors that maintain and aggravate psychosomatic diseases in Africans. Certain coping behaviors over time can induce stress-activation of the sympathetic nervous system (SNS) and the hypothalamus-pituitary-adrenal cortex (HPA) axis leading to changes in stress hormone levels and cardiovascular adjustments that may increase hypertension risks. Recent research indicated that a dissociation of physiological but not behavioral coping styles of Africans during urbanization occurs. An even more disturbed cardiovascular, endocrine and psychological profile was associated with a specific coping style which inevitably poses two questions: Firstly, is only urbanization responsible for these changes and secondly,does a specific coping style (behaviorally and physiologically) during urbanization still have the same outcome when compared to that seen in a rural setting? It, therefore, accentuates the need to explore the dynamics of coping styles of Africans on health indicators during psychosocial stress/urbanization. By addressing these issues valuable contributions can be made by inducing the acquisition of certain coping strategies in formative years.