Department of Family Medicine, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta
Directorate for Information and Research, 95, Telgha ta' Gwardamangia, Tal-Pieta, PTA 1313, Malta
Rural Remote Health. 2020 Nov;20(4):5666. doi: 10.22605/RRH5666. Epub 2020 Nov 19.
Social factors might bring about health inequities. Vulnerable population groups, including those suffering from non-communicable diseases such as type 2 diabetes and depression, might be more prone to suffering the effects of such inequities. This study aimed to identify patients with type 2 diabetes with depression in a primary care setting, with the objective of describing health inequities among urban and suburban dwellers.
A quantitative, retrospective and descriptive study was carried out among patients with diabetes attending public primary healthcare centres in different regions of Malta. Participants completed a self-administered questionnaire to identify patient and disease characteristics. Convenience sampling was used.
The logistic regression model predicting the likelihood of different factors occurring with suburban patients with diabetes as opposed to those residing in urban areas contained five independent variables (severity of depression, monthly income, blood capillary glucose readings, weight and nationality). The full model containing all predictors was statistically significant, c2 (5, n=400), p<0.001, indicating that the model was able to distinguish between urban and suburban areas. The model as a whole explained between 10% (Cox and Snell R2) and 20% (Nagelkerke R2) of the variance in urban and suburban areas, and correctly classified 73.8% of cases. All five of the independent variables made a unique, statistically significant contribution to the model. Elevated blood glucose and obesity tended to be more prevalent in suburban respondents than in urban participants. Conversely, participants with diabetes living in urban areas were more likely to be depressed, non-Maltese and have a higher income.
Despite the small size of the Maltese islands and the expected social homogeneity, health inequities still exist, highlighting the importance of social factors in the epidemiology of disease. This study provides information for healthcare professionals and policy-makers to mitigate the effects of social inequities on vulnerable population groups.
社会因素可能导致健康不平等。弱势群体，包括患有 2 型糖尿病和抑郁症等非传染性疾病的人群，可能更容易受到这种不平等的影响。本研究旨在确定初级保健环境中患有 2 型糖尿病和抑郁症的患者，目的是描述城市和郊区居民之间的健康不平等。
在马耳他不同地区的公共初级保健中心，对患有糖尿病的患者进行了一项定量、回顾性和描述性研究。参与者完成了一份自我管理问卷，以确定患者和疾病特征。采用便利抽样法。
预测郊区糖尿病患者与城市地区患者不同因素发生可能性的逻辑回归模型包含五个独立变量（抑郁严重程度、月收入、毛细血管血糖读数、体重和国籍）。包含所有预测因子的完整模型在统计学上是显著的，c2（5，n=400），p<0.001，表明该模型能够区分城市和郊区。总体而言，该模型能够解释城市和郊区 10%（Cox 和 Snell R2）到 20%（Nagelkerke R2）的方差，正确分类了 73.8%的病例。五个独立变量都对模型做出了独特的、统计学上显著的贡献。郊区受访者的血糖升高和肥胖倾向更为普遍，而城市参与者则更有可能抑郁、非马耳他人且收入更高。
尽管马耳他群岛面积较小，社会同质性预计较高，但仍存在健康不平等现象，这凸显了社会因素在疾病流行病学中的重要性。本研究为医疗保健专业人员和政策制定者提供了信息，以减轻社会不平等对弱势群体的影响。
