Jeon Young-Jee, Kim Chung Reen, Park Joo-Sung, Choi Kyung-Hyun, Kang Myoung Joo, Park Seung Guk, Park Young-Jin
Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Rehabilitation Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877, Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Republic of Korea.
BMC Public Health. 2016 Jun 10;16:492. doi: 10.1186/s12889-016-3169-8.
This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. In addition, the rate of good hypertension or diabetes control was examined separately in men and women, and in urban and rural areas.
This study used Korea National Health and Nutrition Examination V (2010-2012) data, a nationwide cross-sectional survey of general South Korean population. Residential areas were categorized into urban and rural areas. To examine differences between the residential areas in terms of prevalence, awareness, treatment, and control of hypertension and diabetes we performed a multivariate logistic regression adjusting for age, body mass index, physical activity, alcohol use, smoking, marital status, monthly income, and educational level. To investigate control of hypertension or diabetes within each residential area, we performed a subgroup analysis in both urban and rural areas.
The prevalence of hypertension is higher among men in urban areas than among those in rural areas (OR = 0.80; 95 % CI = 0.67-0.96, reference group = urban areas). However, the subgroups did not differ in terms of diabetes prevalence, awareness, treatment, and control. Regardless of both sex and residential area, participants in good control of their hypertension and diabetes were younger. Inequality in good control of hypertension was observed in men who lived in urban (≤Elementary school, OR 0.74, 95 % CI 0.60-0.92) and rural areas (≤Elementary school, OR 0.67, 95 % CI 0.46-0.99). Inequality in health status was found in women who resided in urban areas (≤Elementary school, OR 0.53, 95 % CI 0.37-0.75). Good control of diabetes also showed inequalities in health status for both men (≤Elementary school, OR 0.61, 95 % CI 0.40-0.94; Middle/High school, OR 0.69, 95 % CI 0.49-0.96) and women in urban areas (≤1 million won, OR 0.56, 95 % CI 0.33-0.93) (Reference group = '≥College' for education and '>3 million' Korean won for income).
After correction for individual socioeconomic status, differences by residential area were not observed. However, when the participants with good disease control were divided by region, inequality was confirmed in urban residents. Therefore, differentiated health policies to resolve individual and regional health inequalities are necessary.
本研究调查了高血压和糖尿病的患病率、知晓率、治疗率及控制率在不同居住地区是否存在差异。此外，还分别对男性和女性、城市和农村地区的高血压或糖尿病良好控制率进行了研究。
本研究使用了韩国国家健康与营养检查第五轮（2010 - 2012年）的数据，这是一项针对韩国普通人群的全国性横断面调查。居住地区分为城市和农村地区。为了研究高血压和糖尿病在患病率、知晓率、治疗率及控制率方面的居住地区差异，我们进行了多因素逻辑回归分析，并对年龄、体重指数、身体活动、饮酒、吸烟、婚姻状况、月收入和教育水平进行了调整。为了调查每个居住地区内高血压或糖尿病的控制情况，我们在城市和农村地区都进行了亚组分析。
城市男性高血压患病率高于农村男性（OR = 0.80；95%CI = 0.67 - 0.96，参照组 = 城市地区）。然而，各亚组在糖尿病患病率、知晓率、治疗率及控制率方面没有差异。无论性别和居住地区如何，高血压和糖尿病控制良好的参与者都较为年轻。在城市（小学及以下学历，OR 0.74，95%CI 0.60 - 0.92）和农村地区（小学及以下学历，OR 0.67，95%CI 0.46 - 0.99）的男性中，观察到高血压良好控制方面存在不平等。在城市居住的女性中发现健康状况不平等（小学及以下学历，OR 0.53，95%CI 0.37 - 0.75）。糖尿病的良好控制在城市男性（小学及以下学历，OR 0.61，95%CI 0.40 - 0.94；初中/高中学历，OR 0.69，95%CI 0.49 - 0.96）和女性（收入≤100万韩元，OR 0.56，95%CI 0.33 - 0.93）中也显示出健康状况的不平等（教育方面参照组 = “大专及以上”，收入方面参照组 = “>300万”韩元）。
校正个体社会经济地位后，未观察到居住地区差异。然而，当按地区划分疾病控制良好的参与者时，城市居民中存在不平等得到了证实。因此，有必要制定差异化的卫生政策来解决个体和地区的健康不平等问题。
