Valentelyte Gintare, Holman Naomi, James Steven, Clarke Nicholas, Bhatia Dominika, Bennett Kathleen, Sorensen Jan, Gregg Edward W
Centre for Chronic Disease and Population Health Research, School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Department of Epidemiology and Biostatistics, Imperial College London, London, UK.
BMC Public Health. 2025 Jul 2;25(1):2206. doi: 10.1186/s12889-025-23022-6.
A large variation in diabetes prevalence by socioeconomic status (SES) persists internationally. This study aimed to quantify the prevalence of diabetes by age and SES and explore the current levels of inequality in the prevalence of diabetes in Ireland.
Annual cross-sectional self-reported diabetes data from the national population-based Healthy Ireland Survey for 2015-2023 (n = 59,933) were utilised. Highest educational attainment and area-based deprivation were used as SES indicators. Additionally, the differences in diabetes prevalence across population age-groups were reported. Socioeconomic differences and change in inequality over time were quantified using the relative index of inequality (RII). Logistic regression was used to estimate the relative risk (RR) for having self-reported diabetes according to age and SES, adjusted for sex and survey year.
Diabetes prevalence was highest among individuals aged > 75 years (13.1%) compared to those aged < 40 years (1.0%). Similarly, prevalence was highest among the least educated (8.1%; RR = 2.73; 95% CI = 2.38, 3.13) compared to most educated (1.7%) and individuals living in most deprived areas (6.0%; RR = 2.18; 95% CI = 1.76, 2.70) compared to least deprived areas (2.2%). Additionally, the magnitude of relative inequalities as determined by education level were more than twofold greater than the magnitude of inequalities determined by area-based deprivation. Relative inequalities among individuals with diabetes persisted over the period 2015-2023 among the least educated (RII = 3.9; 95% CI = 3.3,4.6) and individuals living in the most deprived areas (RII = 3.65; 95% CI = 2.4,5.5). A slight increase in relative inequalities among the least educated, and a slight decline in relative inequalities among the most deprived was observed, however, these changes over time were not statistically significant.
This is the first study to examine the socioeconomic variation of diabetes prevalence at the Irish population level. Significant differences in diabetes prevalence persist. With the ageing Irish population, this study highlights the need to consider potential effects of diabetes across the older populations and the lowest socioeconomic status groups when implementing equity-oriented diabetes prevention and management programmes.
社会经济地位（SES）导致的糖尿病患病率在国际上存在很大差异。本研究旨在按年龄和社会经济地位对糖尿病患病率进行量化，并探讨爱尔兰糖尿病患病率目前的不平等程度。
利用基于全国人口的2015 - 2023年爱尔兰健康调查的年度横断面自我报告糖尿病数据（n = 59,933）。将最高教育程度和基于区域的贫困程度用作社会经济地位指标。此外，还报告了不同人口年龄组的糖尿病患病率差异。使用不平等相对指数（RII）对社会经济差异和不平等随时间的变化进行量化。采用逻辑回归估计根据年龄和社会经济地位自我报告患糖尿病的相对风险（RR），并对性别和调查年份进行了调整。
与年龄小于40岁的人群（1.0%）相比，75岁以上人群的糖尿病患病率最高（13.1%）。同样，受教育程度最低的人群患病率最高（8.1%；RR = 2.73；95% CI = 2.38, 3.13），而受教育程度最高的人群患病率为1.7%；与最贫困地区的人群（6.0%；RR = 2.18；95% CI = 1.76, 2.70）相比，最不贫困地区的人群患病率为2.2%。此外，由教育水平决定的相对不平等程度比由基于区域的贫困程度决定的不平等程度高出两倍多。2015 - 2023年期间，受教育程度最低的人群（RII = 3.9；95% CI = 3.3, 4.6）和生活在最贫困地区的人群（RII = 3.65；95% CI = 2.4, 5.5）中，糖尿病患者的相对不平等情况持续存在。观察到受教育程度最低的人群中相对不平等略有增加，最贫困人群中相对不平等略有下降，然而，这些随时间的变化在统计学上并不显著。
这是第一项在爱尔兰人口层面研究糖尿病患病率社会经济差异的研究。糖尿病患病率存在显著差异。随着爱尔兰人口老龄化，本研究强调在实施以公平为导向的糖尿病预防和管理计划时，需要考虑糖尿病对老年人群和社会经济地位最低群体的潜在影响。
