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Socio-Economic Inequality in Prevalence of Type 2 Diabetes Among Adults in North-West of Iran: A Blinder-Oaxaca Decomposition Publisher



Pourfarzi F1 ; Rezaei S2 ; Malekzadeh R3 ; Etemadi A4 ; Zahirian Moghadam T5 ; Zandian H5, 6
Authors
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Authors Affiliations
  1. 1. Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  2. 2. Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
  3. 3. Digestive Oncology Research Center, Digestive Diseases Research Institute, Shariati Hospital, Tehran University of Medical Sciences School of Commerce, Tehran, Iran
  4. 4. Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, United States
  5. 5. Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
  6. 6. Department of Community Medicine, School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran

Source: Journal of Diabetes and Metabolic Disorders Published:2022


Abstract

Background: The aim of this study was to estimate the socio-economic inequality in prevalence of type 2 diabetes among adults in north-west of Iran. Methods: A cross-sectional study was conducted in Ardabil with data from the PERSIAN Cohort Study. Diabetes has been measured by combining self-reported and clinical records. Based on the socio-economic status score, households divided into five quintiles. A multiple logistic regression model was used to examine the association between having diabetes and independent variables and the Blinder–Oaxaca (BO) method was used to decompose the socioeconomic inequality, respectively. Results: The Overall age-adjusted prevalence of diabetes among 20,419 Ardabil’s adults was 14.3% (95% CI: 13.6 to 14.9). The prevalence of type 2 diabetes for the poorest and richest groups was 16.07% and 7.60%, the gap between the poorest and richest groups was 8.47%. The prevalence type 2 diabetes was significantly increasing with increasing in age (OR = 4.05, 95% CI = 3.27–5.02), BMI (OR: 3.10, 95%CI = 1.25–7.68), blood pressure (OR: 2.61, 95% CI = 2.37–2.88), and decreases with higher education level (OR = 0.78, 95% CI = 0.63–0.97). The richest-economic group has lower prevalence of diabetes (OR = 0.73, 95% CI = 0.60–0.88). The decomposition showed that most important factors affecting the difference between poorest and richest group in the prevalence of type 2 diabetes were age (86.1%), years of schooling (46.9%) and having chronic diseases such as hypertension (26.9%). Conclusions: The present study showed that the prevalence of type 2 diabetes was significantly higher among the elderly, women, uneducated, obese, and poor populations. Policies that address people poverty such as increasing job opportunities, increasing the minimum income etc. could reduce diabetes risk for poor people. © 2022, The Author(s), under exclusive licence to Tehran University of Medical Sciences.
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