Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) -UMR_S 1085, F-97100, Pointe-à-Pitre, France.
Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique (IPLESP), F75012, Paris, France.
BMC Public Health. 2019 Oct 30;19(1):1424. doi: 10.1186/s12889-019-7802-1.
Tobacco smoking, alcohol and obesity are important risk factors for a number of non-communicable diseases. The prevalence of these risk factors differ by socioeconomic group in most populations, but this socially stratified distribution may depend on the social and cultural context. Little information on this topic is currently available in the Caribbean. The aim of this study was to describe the distribution of tobacco smoking, alcohol drinking and obesity by several socioeconomic determinants in the French West Indies (FWI).
We used data from a cross-sectional health survey conducted in Guadeloupe and Martinique in 2014 in a representative sample of the population aged 15-75 years (n = 4054). All analyses were stratified by gender, and encompassed sample weights, calculated to account for the sampling design and correct for non-response. For each risk factor, we calculated weighted prevalence by income, educational level, occupational class and having hot water at home. Poisson regression models were used to estimate age-adjusted prevalence ratios (PR) and 95% confidence intervals (CI).
Current smoking and harmful chronic alcohol use were more common in men than in women (PR = 1.80, 95% CI = 1.55-2.09; PR = 4.53, 95% CI = 3.38-6.09 respectively). On the other hand, the prevalence of obesity was higher in women than in men (PR = 0.67, 95% CI = 0.57-0.79). Higher education, higher occupational class and higher income were associated with lower prevalence of harmful alcohol drinking in men (PR = 0.43, 95% CI = 0.25-0.72; PR = 0.73, 95% CI = 0.53-1.01; PR = 0.72, 95% CI = 0.51-1.03 respectively), but not in women. For tobacco smoking, no variation by socioeconomic status was observed in men whereas the prevalence of current smoking was higher among women with higher occupational class (PR = 1.47, 95% CI = 1.13-1.91) and higher income (PR = 1.50, 95% CI = 1.11-2.03). In women, a lower prevalence of obesity was associated with a higher income (PR = 0.43, 95% CI = 0.33-0.56), a higher occupational class (PR = 0.63, 95% CI = 0.50-0.80), a higher educational level (PR = 0.36, 95% CI = 0.26-0.50) and having hot water at home (PR = 0.65, 95% CI = 0.54-0.80).
Women of high socio-economic status were significantly more likely to be smokers, whereas alcohol drinking in men and obesity in women were inversely associated with socioeconomic status.
吸烟、饮酒和肥胖是多种非传染性疾病的重要危险因素。在大多数人群中，这些危险因素的流行程度因社会经济群体而异，但这种社会分层分布可能取决于社会和文化背景。目前在加勒比地区关于这个话题的信息很少。本研究的目的是描述法属西印度群岛（FWI）中几种社会经济决定因素与吸烟、饮酒和肥胖的分布情况。
我们使用了 2014 年在瓜德罗普岛和马提尼克岛进行的一项代表性横断面健康调查的数据，调查对象为 15-75 岁的人群（n=4054）。所有分析均按性别分层，并包括样本权重，这些权重是根据抽样设计计算的，用于纠正无应答情况。对于每个风险因素，我们按收入、教育水平、职业阶层和家中是否有热水进行加权患病率计算。使用泊松回归模型估计年龄调整后的患病率比（PR）和 95%置信区间（CI）。
目前吸烟和慢性酗酒在男性中比在女性中更为常见（PR=1.80，95%CI=1.55-2.09；PR=4.53，95%CI=3.38-6.09）。另一方面，女性肥胖的患病率高于男性（PR=0.67，95%CI=0.57-0.79）。在男性中，较高的教育程度、较高的职业阶层和较高的收入与较低的慢性酗酒患病率相关（PR=0.43，95%CI=0.25-0.72；PR=0.73，95%CI=0.53-1.01；PR=0.72，95%CI=0.51-1.03），但在女性中并非如此。在男性中，吸烟没有表现出与社会经济地位的变化有关，而在女性中，职业阶层较高的女性（PR=1.47，95%CI=1.13-1.91）和收入较高的女性（PR=1.50，95%CI=1.11-2.03）当前吸烟的比例较高。在女性中，较低的肥胖患病率与较高的收入（PR=0.43，95%CI=0.33-0.56）、较高的职业阶层（PR=0.63，95%CI=0.50-0.80）、较高的教育水平（PR=0.36，95%CI=0.26-0.50）和家中有热水（PR=0.65，95%CI=0.54-0.80）有关。
社会经济地位较高的女性更有可能吸烟，而男性饮酒和女性肥胖与社会经济地位呈负相关。
