Agència de Salut Pública de Barcelona, Spain.
Eur J Public Health. 2012 Dec;22(6):765-71. doi: 10.1093/eurpub/ckr158. Epub 2011 Oct 29.
To analyse trends in socio-economic inequalities in the prevalence of diabetes among men and women aged ≥35 years in Spain during the period 1987-2006.
We analysed trends in the age-standardized prevalence of self-reported diabetes and obesity in relation to level of education using data from the Spanish National Health Survey for the years 1987, 1993, 1995, 1997, 2001, 2003 and 2006 (86 345 individuals aged ≥35 years). To assess the relationship between education level and diabetes and obesity, we computed the Slope Index of Inequality and the Relative Index of Inequality (RII) for each year. Additional models were fit to take into account mediator variables in socio-economic position (SEP) diabetes inequalities.
The prevalence of self-reported diabetes was higher among persons of low educational level, increasing more rapidly over time among people with lower education level (5.0-12.6% in men, and 8.4-13.1% in women between 1987 and 2006) than among those with higher education level (6.3-8.7% in men and 3.8-4.0% in women). Relative inequalities showed a weak tendency to increase. In women, the RII of self-reported diabetes increased from 3.04 (1.95-4.74) in 1987 to 4.28 (2.98-6.13) in 2006, while in men were constant since 1993. Trends in SEP inequalities in diabetes prevalence were attenuated when mediator variables were taken into account in women but not in men.
SEP inequalities in diabetes existed >20 years ago and have increased, especially among women. These patterns may be explained by trends in health behaviours and obesity, but only to a limited extent.
分析 1987 年至 2006 年期间，西班牙≥35 岁男性和女性糖尿病患病率的社会经济不平等趋势。
我们使用西班牙国家健康调查的数据（1987 年、1993 年、1995 年、1997 年、2001 年、2003 年和 2006 年≥35 岁的 86345 人），分析了自我报告的糖尿病和肥胖患病率与教育水平之间的年龄标准化趋势。为了评估教育水平与糖尿病和肥胖之间的关系，我们计算了每年的不平等斜率指数和相对不平等指数（RII）。为了考虑社会经济地位（SEP）糖尿病不平等的中介变量，我们还拟合了其他模型。
低教育水平人群的自我报告糖尿病患病率较高，随着时间的推移，教育水平较低的人群的患病率增长更快（1987 年至 2006 年期间，男性为 5.0-12.6%，女性为 8.4-13.1%），高于教育水平较高的人群（男性为 6.3-8.7%，女性为 3.8-4.0%）。相对不平等有微弱的增加趋势。在女性中，自我报告糖尿病的 RII 从 1987 年的 3.04（1.95-4.74）增加到 2006 年的 4.28（2.98-6.13），而在男性中自 1993 年以来一直保持不变。当考虑到女性中介变量时，糖尿病患病率的 SEP 不平等趋势有所减弱，但在男性中则不然。
二十多年前就存在社会经济地位不平等与糖尿病之间的关系，并有所加剧，尤其是在女性中。这些模式可能可以通过健康行为和肥胖趋势来解释，但只是在一定程度上。
