Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.
BMJ Open. 2024 Apr 30;14(4):e080611. doi: 10.1136/bmjopen-2023-080611.
We aimed to examine associations between educational level, serving as an indicator of socioeconomic position, and prevalence of WHO-established leading behavioural and biological risk factors for non-communicable diseases (NCDs), in middle-aged to older women and men.
Population-based cross-sectional study.
All inhabitants of the municipality of Tromsø, Norway, aged ≥40 years, were invited to the seventh survey (2015-2016) of the Tromsø Study; an ongoing population-based cohort study.
Of the 32 591 invited; 65% attended, and a total of 21 069 women (53%) and men aged 40-99 years were included in our study.
We assessed associations between educational level and NCD behavioural and biological risk factors: daily smoking, physical inactivity (sedentary in leisure time), insufficient fruit/vegetable intake (<5 units/day), harmful alcohol use (>10 g/day in women, >20 g/day in men), hypertension, obesity, intermediate hyperglycaemia and hypercholesterolaemia. These were expressed as odds ratios (OR) per unit decrease in educational level, with 95% CIs, in women and men.
In women (results were not significantly different in men), we observed statistically significant associations between lower educational levels and higher odds of daily smoking (OR 1.69; 95% CI 1.60 to 1.78), physical inactivity (OR 1.38; 95% CI 1.31 to 1.46), insufficient fruit/vegetable intake (OR 1.54, 95% CI 1.43 to 1.66), hypertension (OR 1.25; 95% CI 1.20 to 1.30), obesity (OR 1.23; 95% CI 1.18 to 1.29), intermediate hyperglycaemia (OR 1.12; 95% CI 1.06 to 1.19), and hypercholesterolaemia (OR 1.07; 95% CI 1.03 to 1.12), and lower odds of harmful alcohol use (OR 0.75; 95% CI 0.72 to 0.78).
We found statistically significant educational gradients in women and men for all WHO-established leading NCD risk factors within a Nordic middle-aged to older general population. The prevalence of all risk factors increased at lower educational levels, except for harmful alcohol use, which increased at higher educational levels.
本研究旨在探讨以教育程度为社会经济地位指标，与非传染性疾病（NCD）的世界卫生组织（WHO）确立的主要行为和生物风险因素之间的关联，这些风险因素存在于中年至老年的女性和男性中。
基于人群的横断面研究。
挪威特罗姆瑟市的所有居民，年龄≥40 岁，均受邀参加特罗姆瑟研究的第七次调查（2015-2016 年）；这是一项正在进行的基于人群的队列研究。
在受邀的 32591 人中，有 65%的人参加了调查，共有 21069 名 40-99 岁的女性（53%）和男性被纳入我们的研究。
我们评估了教育程度与 NCD 行为和生物风险因素之间的关联：每日吸烟、身体活动不足（休闲时间久坐）、水果/蔬菜摄入量不足（<5 份/天）、有害饮酒（女性>10g/天，男性>20g/天）、高血压、肥胖、中间高血糖和高胆固醇血症。这些关联以每降低一个单位的教育程度表示，置信区间为 95%，适用于女性和男性。
在女性中（男性结果无显著差异），我们观察到较低的教育水平与更高的每日吸烟几率（比值比[OR] 1.69；95%置信区间[CI] 1.60 至 1.78）、身体活动不足（OR 1.38；95%CI 1.31 至 1.46）、水果/蔬菜摄入量不足（OR 1.54；95%CI 1.43 至 1.66）、高血压（OR 1.25；95%CI 1.20 至 1.30）、肥胖（OR 1.23；95%CI 1.18 至 1.29）、中间高血糖（OR 1.12；95%CI 1.06 至 1.19）和高胆固醇血症（OR 1.07；95%CI 1.03 至 1.12）呈统计学显著关联，与有害饮酒（OR 0.75；95%CI 0.72 至 0.78）的几率较低有关。
我们发现，在一个北欧中年至老年的普通人群中，所有由世界卫生组织确定的主要 NCD 风险因素在女性和男性中都存在统计学显著的教育梯度。除了有害饮酒，所有风险因素在教育程度较低的人群中更为普遍，而在教育程度较高的人群中则较低。
