Health Technology Assessment and Health Economics Department, Institute for Clinical Effectiveness and Health Policy, Buenos Aires C1414CPV, Argentina.
Centro de Excelencia en Investigaciones Económicas y Sociales en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima 15024, Peru.
Int J Environ Res Public Health. 2022 Jul 22;19(15):8888. doi: 10.3390/ijerph19158888.
This study measured the socioeconomic inequalities in the prevalence of diabetes between 2005 and 2018 in an urban Argentinian population. Data were obtained from the repeated cross-sectional surveys “National Survey of Risk Factors” (ENFR is its acronym in Spanish). From 2005 to 2018, four rounds of ENFR were administered to men and women over 18 years of age. Concentration curves (CC) and the Erreygers concentration index (ECI) were used to describe the socioeconomic inequalities in diabetes’ prevalence. A decomposition analysis was performed to determine the contribution of each variable to inequality in diabetes’ prevalence. Data from 41,219 (2005), 34,583 (2009), 32,232 (2013), and 29,094 (2018) individuals were analyzed. Women reported a greater prevalence of diabetes compared with men for all the years included. According to the CC and ECI, we found no evidence of inequality in men throughout all study years. For women, throughout all years, the CCs were above the line of equity, and the ECIs during all the years were negative and different from zero (p < 0.01). For women, we found no evidence of a reduction in inequalities between 2005 and 2018 (p = 0.475). The socioeconomic inequality for women was largely driven by public insurance, primary and secondary education, and employment. Diabetes’ prevalence was not associated with socioeconomic status in men, while the prevalence of diabetes in women was more concentrated among poorer women. During the 13 years, there was no evidence of a reduction of inequality in women, noting that interventions must prioritize and should focus on the main contribution of inequalities, such as education and employment.
本研究旨在衡量 2005 年至 2018 年期间阿根廷城市居民中糖尿病的社会经济不平等状况。数据来自重复的横断面调查“国家风险因素调查”（西班牙语缩写为 ENFR）。2005 年至 2018 年，对 18 岁以上的男性和女性进行了四轮 ENFR 调查。使用集中曲线（CC）和 Erreygers 集中指数（ECI）来描述糖尿病患病率的社会经济不平等。进行了分解分析，以确定每个变量对糖尿病患病率不平等的贡献。对 41219 名（2005 年）、34583 名（2009 年）、32232 名（2013 年）和 29094 名（2018 年）个体的数据进行了分析。所有年份的女性报告的糖尿病患病率均高于男性。根据 CC 和 ECI，我们没有发现男性在所有研究年份存在不平等的证据。对于女性，所有年份的 CC 均高于公平线，所有年份的 ECI 均为负值且与零不同（p<0.01）。对于女性，我们没有发现 2005 年至 2018 年期间不平等程度降低的证据（p=0.475）。女性的社会经济不平等主要归因于公共保险、小学和中学教育以及就业。男性的糖尿病患病率与社会经济地位无关，而女性的糖尿病患病率在贫困女性中更为集中。在这 13 年中，没有证据表明女性的不平等程度有所降低，这表明干预措施必须优先考虑并重点关注不平等的主要贡献因素，如教育和就业。
