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对比社会经济不平等与非传染性疾病:基于香港队列研究中使用集中指数的人群调查的见解

Contrasting socioeconomic inequality with noncommunicable diseases: Insights from a population-based survey using the concentration index in Kong cohort study.

作者信息

Mouseli Ali, Sharafi Mehdi, Mastaneh Zahra, Shiri Maryam Shiravani

机构信息

Social Determinants in Health Promotion Research Center, Hormozgan Health Institute Hormozgan University of Medical Sciences Bandar Abbas Iran.

Department of Health Services Management, School of Health Hormozgan University of Medical Sciences Bandar Abbas Iran.

出版信息

Health Sci Rep. 2023 Nov 5;6(11):e1682. doi: 10.1002/hsr2.1682. eCollection 2023 Nov.

Abstract

BACKGROUND

Noncommunicable diseases (NCDs) are the major causes of mortality across the globe, which impose a substantial burden on health care systems, particularly in low- and middle-income countries. The present study aimed to determine socioeconomic inequality in the prevalence of NCDs using the concentration index (CI).

METHODS

This cross-sectional study was conducted on the baseline data of the Bandar Kong cohort. The principal component analysis was used to determine people's socioeconomic status (SES). The CI and Lorenz Curve were used for the assessment of socioeconomic inequality. Multivariate logistic regression was used to assess the relationship between SES and the prevalence of NCDs. A Value less than 0.05 is considered significant.

RESULTS

Frequency and prevalence of diabetes was 653 (16.22%), hypertension 848 (21.06%), chronic lung diseases 161 (4%), epilepsy 70 (1.74%), mental disorders 191 (4.74%), stillbirth 299 (13.94%), thyroid disorders 391 (9.71%) and depression 146 (3.63%). CI for the prevalence of diabetes was [-0.107, %95 CI: -0.146 to -0.068], hypertension [-0.122, %95 CI: -0.155 to -0.088], chronic lung disease [-0.116, %95 CI: -0.202 to -0.03], psychiatric disorders [-0.230, %95 CI: -0.304 to -0.155], depression [-0.132, %95 CI: -0.220 to-0.043] and stillbirth [-0.162, %95 CI: -0.220 to -0.105]. The Gini index was negative for all these diseases, indicating that these are significantly concentrated in people of poor SES.

CONCLUSIONS

The findings suggest that selected NCDs were concentrated among the poor and the low-income. Particular attention may be necessary to address the problem of NCDs among these groups.

摘要

背景

非传染性疾病(NCDs)是全球主要的死亡原因,给医疗保健系统带来了沉重负担,尤其是在低收入和中等收入国家。本研究旨在使用集中指数(CI)确定非传染性疾病患病率的社会经济不平等情况。

方法

本横断面研究基于班达尔孔队列的基线数据进行。主成分分析用于确定人们的社会经济地位(SES)。集中指数和洛伦兹曲线用于评估社会经济不平等。多变量逻辑回归用于评估社会经济地位与非传染性疾病患病率之间的关系。P值小于0.05被认为具有统计学意义。

结果

糖尿病的发病率和患病率分别为653例(16.22%)、高血压848例(21.06%)、慢性肺病161例(4%)、癫痫70例(1.74%)、精神障碍191例(4.74%)、死产299例(13.94%)、甲状腺疾病391例(9.71%)和抑郁症146例(3.63%)。糖尿病患病率的集中指数为[-0.107,95%置信区间:-0.146至-0.068],高血压为[-0.122,95%置信区间:-0.155至-0.088],慢性肺病为[-0.116,95%置信区间:-0.202至-0.03],精神疾病为[-0.230,95%置信区间:-0.304至-0.155],抑郁症为[-0.132,95%置信区间:-0.220至-0.043],死产为[-0.162,95%置信区间:-0.220至-0.105]。所有这些疾病的基尼指数均为负数,表明这些疾病在社会经济地位较低的人群中显著集中。

结论

研究结果表明,选定的非传染性疾病集中在贫困和低收入人群中。可能需要特别关注这些群体中的非传染性疾病问题。

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