Cross-country variation in additive effects of socio-economics, health behaviors, and comorbidities on subjective health of patients with diabetes
Cross-country variation in additive effects of socio-economics, health behaviors, and comorbidities on subjective health of patients with diabetes
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DOI：
10.1186/2251-6581-13-36
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发表时间：
2014-01-01
影响因子：
2.8
通讯作者：
Assari, Shervin
中科院分区：
文献类型：
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作者：
Assari, Shervin
目的：探讨社会经济特征、健康行为和医疗合并症对糖尿病患者主观健康的相加效应的跨国差异。方法：本研究分析了《早期生活与老龄化趋势与影响研究》(Relate)的数据。参与者是来自15个国家(即中国、哥斯达黎加、波多黎各、美国、墨西哥、阿根廷、巴巴多斯、巴西、智利、古巴、乌拉圭、印度、加纳、南非和俄罗斯)的9,179名成年糖尿病患者。我们对每个国家进行了三次Logistic回归。模式一只包括社会经济特征(即年龄、性别、教育和收入)。在模型II中，我们还包括了健康行为(即吸烟、饮酒和锻炼)。模型三包括医学并存(即高血压、呼吸系统疾病、心脏病、中风和关节炎)。结果：我们的模型表明，社会经济特征、健康行为和并存对糖尿病患者感知健康的相加效应存在跨国差异。心脏病是唯一一种与主观健康状况不佳有关的疾病，无论来自哪个国家。结论：不同国家的糖尿病患者主观健康的社会和行为决定因素不同。我们的研究表明，假设不同国家幸福的决定因素相似的普遍计划可能过于简单化了。因此，应该在每个国家实施当地设计的干预措施，而不是在所有国家使用一种促进患者健康的通用方案。
Purpose: This study explored cross-country differences in the additive effects of socio-economic characteristics, health behaviors and medical comorbidities on subjective health of patients with diabetes.Methods: The study analyzed data from the Research on Early Life and Aging Trends and Effects (RELATE). The participants were 9,179 adults with diabetes who were sampled from 15 countries (i.e. China, Costa Rica, Puerto Rico, United States, Mexico, Argentina, Barbados, Brazil, Chile, Cuba, Uruguay, India, Ghana, South Africa, and Russia). We fitted three logistic regressions to each country. Model I only included socio-economic characteristics (i.e. age, gender, education and income). In Model II, we also included health behaviors (i.e. smoking, drinking, and exercise). Model III included medical comorbidities (i.e. hypertension, respiratory disease, heart disease, stroke, and arthritis), in addition to the previous blocks.Results: Our models suggested cross-country differences in the additive effects of socio-economic characteristics, health behaviors and comorbidities on perceived health of patients with diabetes. Comorbid heart disease was the only condition that was consistently associated with poor subjective health regardless of country.Conclusion: Countries show different profiles of social and behavioral determinants of subjective health among patients with diabetes. Our study suggests that universal programs that assume that determinants of well-being are similar across different countries may be over-simplistic. Thus instead of universal programs that use one protocol for health promotion of patients in all countries, locally designed interventions should be implemented in each country.