In sickness and health? Examining the co-occurrence and concordance of healthy lifestyle behaviours among spouses in Namibia

Objectives This study examines the extent to which healthy lifestyle behaviours co-occur in individuals. We also explore within-couples concordance in healthy lifestyle behaviours in Namibia. Study design Cross-sectional study. Methods We used data from 910 couples (1820 individuals) who were interviewed in the Namibia Demographic and Health Survey conducted in 2013. We assessed five different healthy lifestyle behaviours (alcohol non-consumption, non-cigarette smoking, healthy diet, physical exercise, and normal body mass index). An individual healthy lifestyle index (HLI) was derived by summing values across the five behaviours, with a binary indicator categorising each individual's lifestyle behaviour as ‘healthy’ (HLI ≥ 3) or ‘unhealthy’ (HLI < 3). Multivariate logistic regression models were fitted to explore the association between binary indicators of men's and their female partner's healthy lifestyles. Results About 48% of men and 57% of women had at least three co-occurring healthy lifestyle behaviours. A third of couples were concordant in reporting a healthy lifestyle (HLI ≥ 3), while 27% were concordant in reporting an unhealthy lifestyle (HLI < 3). In multivariate analysis, Namibian men were almost twice (aOR, 1.90; 95%CI, 1.43–2.52) as likely to have a healthy lifestyle if their female partner also had a healthy lifestyle, compared with those who had a female partner who had an unhealthy lifestyle, after adjusting for relevant individual, partner and household characteristics. Conclusion The observed co-occurrence of healthy lifestyle behaviours and spousal concordance suggests it may be beneficial to consider couples a target for intervention when aiming to promote healthy behaviours and reduce cardiovascular diseases in Namibia.