Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh.
Socio-Economic Inequality of Chronic Non-Communicable Diseases in Bangladesh.
复制标题
DOI：
10.1371/journal.pone.0167140
复制
发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Rawal LB
中科院分区：
文献类型：
--
作者：
Biswas T;Islam MS;Linton N;Rawal LB
慢性非传染性疾病是一项重大的公共卫生挑战，并破坏了包括孟加拉国在内的许多发展中国家的社会和经济发展。在孟加拉国，与社会经济地位相关的非传染性疾病模式的流行病学证据仍然有限。这项研究评估了孟加拉国人口中三种慢性非传染性疾病与社会经济地位之间的关系，特别注意城市和农村地区之间的差异。本研究使用了2011年孟加拉国人口和健康调查的数据。使用浓度指数（CI），我们测量了孟加拉国城市和农村地区糖尿病前期，糖尿病，高血压前期，高血压和BMI（体重不足，正常体重和超重/肥胖）的相对不平等。CI及其相关曲线可用于确定给定健康变量是否存在社会经济不平等。此外，我们估计了健康成就指数，综合了平均覆盖率和农村和城市人口的覆盖率分布。在各种疾病和风险因素中观察到社会经济不平等。使用CI，观察到高血压前期（CI = 0.09，p = 0.001）、高血压（CI = 0.10，p = 0.001）、糖尿病前期（CI =-0.01，p = 0.005）、糖尿病（CI = 0.19，p<0.001）和超重/肥胖（CI = 0.45，p<0.001）的显著不平等。与城市富裕人群慢性病患病率高相反，高血压前期的CI有显著性差异（CI =-0.20，p = 0.001），高血压（CI =-0.20，p = 0.005），糖尿病前期（CI =-0.15，p = 0.005）、糖尿病（CI =-0.26，p = 0.004）和超重/肥胖（CI = 0.25，p = 0.004）在农村低财富五分位数人口中观察到更多。同样，最贫穷的农村家庭比最富有的农村家庭有更多的合并症（p = 0.003），最富有的城市家庭的合并症患病率比最贫穷的城市家庭高得多。另一方面，在农村，健康指标的“不达标”比城市更明显。调查结果表明，在农村地区低财富五分之一人口和城市地区富裕人口中，某些非传染性疾病的负担很高。可能需要特别注意解决这些群体的非传染性疾病问题。
Chronic non-communicable diseases (NCDs) are a major public health challenge, and undermine social and economic development in much of the developing world, including Bangladesh. Epidemiologic evidence on the socioeconomic status (SES)-related pattern of NCDs remains limited in Bangladesh. This study assessed the relationship between three chronic NCDs and SES among the Bangladeshi population, paying particular attention to the differences between urban and rural areas. Data from the 2011 Bangladesh Demographic and Health Survey were used for this study. Using a concentration index (CI), we measured relative inequality across pre-diabetes, diabetes, pre-hypertension, hypertension, and BMI (underweight, normal weight, and overweight/obese) in urban and rural areas in Bangladesh. A CI and its associated curve can be used to identify whether socioeconomic inequality exists for a given health variable. In addition, we estimated the health achievement index, integrating mean coverage and the distribution of coverage by rural and urban populations. Socioeconomic inequalities were observed across diseases and risk factors. Using CI, significant inequalities observed for pre-hypertension (CI = 0.09, p = 0.001), hypertension (CI = 0.10, p = 0.001), pre-diabetes (CI = -0.01, p = 0.005), diabetes (CI = 0.19, p<0.001), and overweight/obesity (CI = 0.45, p<0.001). In contrast to the high prevalence of the chronic health conditions among the urban richest, a significant difference in CI was observed for pre-hypertension (CI = -0.20, p = 0.001), hypertension (CI = -0.20, p = 0.005), pre-diabetes (CI = -0.15, p = 0.005), diabetes (CI = -0.26, p = 0.004) and overweight/obesity (CI = 0.25, p = 0.004) were observed more among the low wealth quintiles of rural population. In the same vein, the poorest rural households had more co-morbidities compared to the richest rural households (p = 0.003), and prevalence of co-morbidities was much higher for the richest urban households compared to the poorest urban households. On the other hand in rural the “disachievement” of health indicators is more noticeable than the urban ones. The findings indicate the high burden of selected NCDs among the low wealth quintile populations in rural areas and wealthy populations in urban areas. Particular attentions may be necessary to address the problem of NCDs among these groups.
登录
查看更多内容
影响因子：
5.4
作者：
Chalasani, Satvika
通讯作者：
Chalasani, Satvika
影响因子：
168.9
作者：
El Arifeen, Shams;Hill, Kenneth;Streatfield, Peter Kim
通讯作者：
Streatfield, Peter Kim
影响因子：
5.1
作者：
Gupta, Rajeev;Kaul, Vijay;Gupta, V. P.
通讯作者：
Gupta, V. P.
影响因子：
9.3
作者：
D'Orazio, P;Burnett, RW;Okorodudu, AO
通讯作者：
Okorodudu, AO
影响因子：
4
作者：
Gupta R;Guptha S;Joshi R;Xavier D
通讯作者：
Xavier D