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沙特阿拉伯王国糖尿病患病率的健康差异和不平等。

Health disparities and inequalities in prevalence of diabetes in the Kingdom of Saudi Arabia.

机构信息

Department of Health Services and Hospitals Administration, Faculty of Economics and Administration, King Abdulaziz University, Jeddah, Saudi Arabia.

Health Economics Research Group, King Abdulaziz University, Jeddah, Saudi Arabia.

出版信息

Int J Equity Health. 2024 Sep 18;23(1):186. doi: 10.1186/s12939-024-02265-6.

Abstract

BACKGROUND

Over time, global health systems have witnessed significant improvements in the delivery and coverage of healthcare services. Nevertheless, the increasing prominence of non-communicable diseases remains a persistent challenge. Diabetes is one such non-communicable chronic disease that poses a threat with respect to both mortality and morbidity. This study investigated the socio-economic determinants and inequalities in the prevalence of diabetes in the Kingdom of Saudi Arabia according to data collected from the 2018 Saudi Family Health Survey conducted by the General Authority for Statistics.

METHODS

The analysis was limited to a sample of 11,528 respondents aged ≥ 18 years, selected across all 13 regions of Saudi Arabia, with complete responses for all variables of interest. Socio-economic determinants in diabetes prevalence were explored with univariate, bivariate, and multivariate logistic regression analyses. Furthermore, inequalities were visualised and quantitatively estimated according to construction of a concentration curve and calculation of the concentration index.

RESULTS

The prevalence of diabetes among the 11,528 respondents was 11.20%. Age, education, income, and residence area were significant determinants of diabetes prevalence, with a greater risk of diabetes found in older participants (odds ratio [OR]: 12.262, 95% confidence interval [CI]: 9.820-15.313, p < 0.01) compared to younger participants. Inequality analysis showed a negative education-based concentration index (-0.235, p < 0.01), indicating that diabetes prevalence is concentrated among people with relatively less formal education. For males, the income-based concentration index was significantly positive, whereas the education-based concentration index was significantly negative, indicating a greater concentration of diabetes among Saudi men with higher incomes and less education.

CONCLUSION

These findings emphasize the need to prioritize policies and strategies for diabetes prevention and control with considerations of the socio-economic inequalities in prevalence. Key areas of focus should include improving education levels across all regions, raising awareness about diabetes and implementing nutritional interventions.

摘要

背景

随着时间的推移,全球卫生系统在提供和覆盖医疗保健服务方面取得了重大进展。然而,非传染性疾病的日益突出仍然是一个持续存在的挑战。糖尿病是一种非传染性慢性疾病,它在死亡率和发病率方面都构成了威胁。本研究根据沙特统计总局开展的 2018 年沙特家庭健康调查收集的数据,调查了沙特阿拉伯王国糖尿病流行的社会经济决定因素和不平等现象。

方法

该分析仅限于从沙特阿拉伯所有 13 个地区中选择的年龄≥18 岁、对所有感兴趣变量均有完整回答的 11528 名受访者的样本。使用单变量、双变量和多变量逻辑回归分析探讨了糖尿病流行的社会经济决定因素。此外,根据构建集中曲线和计算集中指数,对不平等现象进行了可视化和定量估计。

结果

在 11528 名受访者中,糖尿病的患病率为 11.20%。年龄、教育、收入和居住地区是糖尿病患病率的重要决定因素,与年轻参与者相比,年龄较大的参与者患糖尿病的风险更高(比值比[OR]:12.262,95%置信区间[CI]:9.820-15.313,p<0.01)。不平等分析显示,基于教育的集中指数为负(-0.235,p<0.01),表明糖尿病患病率集中在受教育程度相对较低的人群中。对于男性,基于收入的集中指数显著为正,而基于教育的集中指数显著为负,这表明糖尿病在沙特男性中更为集中,他们的收入较高,受教育程度较低。

结论

这些发现强调了需要优先考虑预防和控制糖尿病的政策和战略,并考虑到流行率方面的社会经济不平等现象。重点关注领域应包括提高所有地区的教育水平,提高对糖尿病的认识并实施营养干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/828a/11409623/c0ec2ea67fd3/12939_2024_2265_Fig1_HTML.jpg

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