Vuković Dejana, Bjegović Vesna, Vuković Goran
School of Medicine Belgrade, Institute of Social Medicine, Dr Subotica 15, Belgrade, Serbia.
Croat Med J. 2008 Dec;49(6):832-41. doi: 10.3325/cmj.2008.49.832.
To examine socioeconomic inequalities in the prevalence of chronic diseases in Serbia, using the data from 2006 national health survey.
A stratified sample of 7673 households was selected and 14522 household members older than 20 years were interviewed (response rate 80.5%). Wealth index was used as a measure of socioeconomic status. Standardized morbidity prevalence ratios were computed using the poorest category as reference. Odds ratios for the prevalence of the selected chronic diseases and their 95% confidence intervals were calculated by multivariate logistic analysis adjusted for age, education, smoking status, and body mass index.
Hypertension was the most prevalent disease in all socioeconomic categories; standardized morbidity prevalence ratios were higher in richer men (151.3 in the richest) and lower in richer women (86.1 in the richest). Rheumatism/arthritis was the second most prevalent disease in both sexes, with the highest prevalence in the poorest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 86.4 in men and 74.0 in women). The prevalence of hyperlipidemia was associated with wealth index in both men and women and was highest in the richest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 275.9 in men and 138.4 in women). Logistic regression models showed that higher wealth index was associated with higher prevalence of hypertension, hyperlipidemia, and allergy, while lower wealth index was associated with higher prevalence of rheumatism/arthritis.
There were considerable socioeconomic inequalities in the prevalence of chronic diseases in Serbia. These results indicate an opportunity to reduce inequalities and show a need for further investigation on the determinants of chronic diseases.
利用2006年全国健康调查数据,研究塞尔维亚慢性病患病率中的社会经济不平等情况。
选取了7673户家庭的分层样本,对14522名20岁以上家庭成员进行了访谈(应答率80.5%)。财富指数用作社会经济地位的衡量指标。以最贫困类别为参照计算标准化发病率患病率比。通过对年龄、教育程度、吸烟状况和体重指数进行调整的多因素逻辑回归分析,计算所选慢性病患病率的比值比及其95%置信区间。
高血压在所有社会经济类别中都是最常见的疾病;标准化发病率患病率比在较富裕男性中较高(最富裕组为151.3),在较富裕女性中较低(最富裕组为86.1)。风湿/关节炎在男女中都是第二常见的疾病,在最贫困组中患病率最高;标准化后模式不变(最富裕组标准化发病率患病率比:男性为86.4,女性为74.0)。高脂血症患病率在男性和女性中均与财富指数相关,在最富裕组中最高;标准化后模式不变(最富裕组标准化发病率患病率比:男性为275.9,女性为138.4)。逻辑回归模型显示,较高的财富指数与高血压、高脂血症和过敏的较高患病率相关,而较低的财富指数与风湿/关节炎的较高患病率相关。
塞尔维亚慢性病患病率存在相当大的社会经济不平等。这些结果表明有机会减少不平等,并显示出对慢性病决定因素进行进一步调查的必要性。