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Global Health Econ Sustain

ORIGINAL RESEARCH ARTICLE
Path modeling of socioeconomic, behavioral,

and environmental attributes of the Ebola
epidemic in West Africa

3
Laurasona Leigh 1 , Colleen Taylor 2 , and Jiunn-Jye Sheu *
1 Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, Maryland,
United States of America
2 College of Nursing, University of Toledo, Toledo, Ohio, United States of America
3 Department of Population Health, College of Health and Human Services, University of Toledo,
Toledo, Ohio, United States of America

Abstract

The 2014 Ebola outbreak stands as one of the most severe outbreaks of the virus,
resulting in approximately 15,227 confirmed cases and 11,310 deaths. Despite
substantial research conducted on the biological and epidemiological features of
the virus, limited attention has been given to how an individual’s health behavior
contributes to its spread. This study aimed to identify socioeconomic, behavioral,
and environmental factors associated with Ebola infection. Guided by the
Socioecological Model of Health, a correlational analysis was conducted using data
Academic editor: from three English-speaking West African countries with the highest Ebola caseloads
Mihajlo Jakovljevic M.D. Ph.D. MAE
and fatalities: Liberia, Nigeria, and Sierra Leone. Each country’s Ministry of Health
*Corresponding author: compiled daily reports on Ebola infections, including confirmed cases and deaths
Jiunn-Jye Sheu
(jiunnjye.sheu@utoledo.edu) within each district. Possible health behavior determinants were gathered from
surveys conducted by each country with the assistance of credible international
Citation: Leigh, L., Taylor, C., &
Sheu, J.J. (2024). Path modeling agencies. Path analysis was then conducted to identify the size and direction of
of socioeconomic, behavioral, and direct and indirect effects associated with an Ebola infection. The results revealed
environmental attributes of the that female unemployment men with some secondary education, availability of
Ebola epidemic in West Africa.
Global Health Econ Sustain, 2(2): hand washing soap, female literacy, and total health expenditure significantly
2
2107. predict initial confirmed cases with an R of 0.41. Along with the predictors of initial
https://doi.org/10.36922/ghes.2107 confirmed cases, the main source of drinking water accounted for 59% (R ) of the
2
Received: October 25, 2023 variance in the latest confirmed deaths. Officials in high-prevalence countries are
suggested to address the availability of soap for hand washing, male secondary
Accepted: February 2, 2024
education proportion, female literacy and unemployment, health expenditure, and
Published Online: May 15, 2024 main sources of drinking water to reduce the transmission of the Ebola virus.
Copyright: © 2024 Author(s).
This is an Open Access article
distributed under the terms of the Keywords: West Africa; Ebola hemorrhagic fever; Ecological model
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium,
provided the original work is
properly cited. 1. Introduction
Publisher’s Note: AccScience The Ebola virus has sporadically emerged around the world, causing devastation in towns,
Publishing remains neutral with villages, and cities, especially in the African region. This lethal virus was first identified
regard to jurisdictional claims in
published maps and institutional in 1976, during simultaneous epidemics in southern Sudan and the northern region of
affiliations. the Democratic Republic of Congo (formerly Zaire). During this initial outbreak, the

Volume 2 Issue 2 (2024) 1 https://doi.org/10.36922/ghes.2107