Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
BRAC James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh.
Trop Med Int Health. 2021 Sep;26(9):1047-1056. doi: 10.1111/tmi.13625. Epub 2021 Jun 1.
To determine the association of household wealth and education level with hypertension and diabetes in Bangladesh using propensity score (PS) analyses.
A nationally representative sample of the Bangladesh Demographic and Health Survey 2017-18 was analysed to explore the research question. A weighted sample of 11 320 individuals was considered. Hypertension and diabetes were the outcomes of interest, and household wealth status (non-poor and poor) and education level (secondary/higher education and no secondary/higher education) were the exposure variables of interest. A person was defined as hypertensive if their average blood pressure was ≥140/90 mmHg or self-reported history of taking antihypertensive medications. Individuals were classified as diabetic if they had a Fasting Blood Glucose level of ≥7 mmol/l or reported taking prescribed medication for reducing high blood glucose or diabetes. We used the 1:1 nearest neighbour PS matching without replacement and PS weighting approaches to assess the association between the exposures and the outcome variables.
Wealth status was significantly associated with diabetes but not with hypertension, while education status was significantly associated with neither diabetes nor hypertension. We also observed a significant interaction effect between household wealth status and education level with diabetes. The odds of diabetes were approximately 60% higher among adults from non-poor households and those without secondary/higher education.
Diabetes prevention and control programs should focus on non-poor individuals, while hypertension prevention programs should target populations irrespective of educational attainment and wealth status.
利用倾向评分（PS）分析，确定孟加拉国家庭财富和教育水平与高血压和糖尿病之间的关联。
对 2017-18 年孟加拉国人口与健康调查的全国代表性样本进行分析，以探讨研究问题。考虑了加权样本量为 11320 人。高血压和糖尿病是感兴趣的结局，家庭财富状况（非贫困和贫困）和教育水平（中等/高等教育和非中等/高等教育）是感兴趣的暴露变量。如果一个人的平均血压≥140/90mmHg 或自述正在服用抗高血压药物，则将其定义为高血压患者。如果空腹血糖水平≥7mmol/L 或报告正在服用降低高血糖或糖尿病的处方药物，则将个体归类为糖尿病患者。我们使用 1:1 最近邻 PS 匹配且不进行替换和 PS 加权方法来评估暴露与结局变量之间的关联。
财富状况与糖尿病显著相关，但与高血压无关，而教育状况与糖尿病和高血压均无显著关联。我们还观察到家庭财富状况和教育水平与糖尿病之间存在显著的交互作用效应。来自非贫困家庭且未接受中等/高等教育的成年人患糖尿病的几率大约高出 60%。
糖尿病预防和控制计划应侧重于非贫困人群，而高血压预防计划应针对所有教育程度和财富状况的人群。
