Hakeem R, Thomas J, Badruddin S H.
Urbanisation and health related knowledge and attitudes of South Asian children.
J Pak Med Assoc Jan ;51(12):437-43.

OBJECTIVE: To study the differences in health related knowledge and attitudes of less and more urbanised 10-12 year old South Asian school children. METHOD: A total of 589 Asian children living in UK and in Pakistan were studied. Three groups of children were recruited from Punjab, Pakistan: rural (RrP, n = 100), middle income urban (MUP, n = 148) and high income urban (HUP, n = 159) and they were assigned urbanization rank (UR) 1, 2 and 3. Another two groups of children were recruited from Slough, UK: British Pakistani (BrP, n = 110) and British Indian (Brl, n = 71) and they were assigned urbanization rank 4 and 5 respectively. Information about Cardiovascular Health (CVH) related knowledge, Health Locus of Control (HLC), smoking behaviour, self-perception of bodyweight and self-perception of activity level was collected through questionnaire. Actual weight status was judged by measuring body height and weight. Actual Physical Activity Level (PAL) was calculated from three day activity records kept by children. RESULTS: In general health related knowledge improved with urbanisation status. In all groups girls scored better on knowledge test than boys from the same group. HLC scores increased (indicate higher level of internal locus of control) steadily with urbanisation from UR 1-3. In most groups girls had slightly lower HLC scores. Smoking intentions were not related to UR. Validity of perceptions slightly improved with urbanisation rank only for activity level. CONCLUSION: Due to lack of knowledge and belief in external health locus of control, behaviour modification is likely to harder in less urbanized Pakistani groups. For the prevention of disease, efforts are required not only to increase the children`s knowledge about health but also to increase awareness and understanding of healthy body weight, physical activity, hazards of smoking and to inculate belief in internal control over own health.

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