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1999 年至 2014 年间,香港女性中由医生诊断的高血压的教育不平等现象扩大并持续存在。

Educational inequality in physician-diagnosed hypertension widened and persisted among women from 1999 to 2014 in Hong Kong.

机构信息

The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.

出版信息

Sci Rep. 2019 Oct 7;9(1):14361. doi: 10.1038/s41598-019-50760-6.

Abstract

Gender differences in the trend of educational inequality in hypertension have been observed especially in the Asian populations, indicating the increasing importance of education as a social determinant of hypertension among women. This study examined the gender-specific trends of educational inequality in physician-diagnosed hypertension in Hong Kong between 1999 and 2014. Based on a series of eight government-led territory-wide household surveys conducted between 1999 and 2014, 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were analysed. The extent and trend of gender-specific educational inequality in self-reported physician-diagnosed hypertension were estimated by regression-based Relative Index of Inequality and age-standardised Slope Index of Inequality. Over the study period, age-standardised prevalence of self-reported hypertension increased in both genders, with the greatest prevalence among the least educated women. Educational inequalities in hypertension significantly widened in female from 1999 to 2009 and persisted thereafter; nonetheless, the respective inequality was negligible in male. Further adjustment for household income did not attenuate the observed inequality. To conclude, a widened and then persistent discrepancy in hypertension across education levels was observed among women, but not among men, in Hong Kong. The gender perspective should be carefully considered when designing hypertension prevention strategies and related health policies.

摘要

性别差异在高血压的教育不平等趋势中尤为明显,尤其是在亚洲人群中,这表明教育作为女性高血压的社会决定因素越来越重要。本研究考察了香港在 1999 年至 2014 年间医生诊断高血压中教育不平等的性别特异性趋势。基于在 1999 年至 2014 年期间进行的一系列八项政府主导的全港性家庭调查,分析了 97481 名年龄在 45 岁或以上的居住在社区的香港华人成年人。通过基于回归的相对不平等指数和年龄标准化斜率不平等指数来估计自我报告的医生诊断高血压的性别特异性教育不平等的程度和趋势。在研究期间,男女两性的年龄标准化自我报告高血压患病率均有所上升,而受教育程度最低的女性患病率最高。女性高血压的教育不平等程度从 1999 年到 2009 年显著扩大,并在此后持续存在;然而,男性的不平等程度可以忽略不计。进一步调整家庭收入并不能减轻观察到的不平等。总之,在香港,女性在不同教育水平的高血压之间存在扩大且持续存在的差异,但男性则没有。在制定高血压预防策略和相关卫生政策时,应谨慎考虑性别视角。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b852/6779914/db37f705786f/41598_2019_50760_Fig1_HTML.jpg

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