دورية أكاديمية
أعرض في EDS

All-cause, premature, and cardiovascular death attributable to socioeconomic and ethnic disparities among New Zealanders with type 1 diabetes 1994-2019: a multi-linked population-based cohort study.

التفاصيل البيبلوغرافية
العنوان: All-cause, premature, and cardiovascular death attributable to socioeconomic and ethnic disparities among New Zealanders with type 1 diabetes 1994-2019: a multi-linked population-based cohort study.
المؤلفون: Yu D; Department of Nephrology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, 450052, China.; Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, ST5 5BG, UK., Cai Y; Department of Nephrology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, 450052, China., Osuagwu UL; School of Medicine, Western Sydney University, Locked Bag 1797, Campbelltown, NSW 2751, Australia., Pickering K; Diabetes Foundation Aotearoa, Otara, New Zealand., Baker J; Diabetes Foundation Aotearoa, Otara, New Zealand.; Department of Diabetes and Endocrinology, Counties Manukau Health, Auckland, New Zealand., Cutfield R; Diabetes Foundation Aotearoa, Otara, New Zealand.; Department of Diabetes and Endocrinology, Waitemata District Health Board, Auckland, New Zealand., Orr-Walker BJ; Diabetes Foundation Aotearoa, Otara, New Zealand.; Department of Diabetes and Endocrinology, Counties Manukau Health, Auckland, New Zealand., Sundborn G; Section of Pacific Health, the University of Auckland, Auckland, New Zealand., Wang Z; Department of Nephrology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, 450052, China., Zhao Z; Department of Nephrology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, 450052, China. zhanzhengzhao@zzu.edu.cn., Simmons D; Department of Nephrology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, 450052, China. Da.Simmons@westernsydney.edu.au.; School of Medicine, Western Sydney University, Locked Bag 1797, Campbelltown, NSW 2751, Australia. Da.Simmons@westernsydney.edu.au.; Diabetes Foundation Aotearoa, Otara, New Zealand. Da.Simmons@westernsydney.edu.au.
المصدر: BMC public health [BMC Public Health] 2024 Jan 25; Vol. 24 (1), pp. 298. Date of Electronic Publication: 2024 Jan 25.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
أسماء مطبوعة: Original Publication: London : BioMed Central, [2001-
مواضيع طبية MeSH: Australasian People* , Cardiovascular Diseases*/epidemiology , Cardiovascular Diseases*/mortality , Diabetes Mellitus, Type 1*/epidemiology , Diabetes Mellitus, Type 1*/mortality, Adult ; Female ; Humans ; Male ; Cohort Studies ; Diabetes Mellitus, Type 2 ; New Zealand/epidemiology ; Socioeconomic Factors
مستخلص: Background: New Zealand (NZ) research into type 1 diabetes mellitus (T1DM) mortality can inform policy and future research. In this study we aimed to quantify the magnitude to which ethnicity and socioeconomic disparities influenced mortality at the population level among people with Type 1 diabetes (T1DM) in Auckland, New Zealand (NZ).
Methods: The cohort data were derived from the primary care diabetes audit program the Diabetes Care Support Service (DCSS), and linked with national primary care, pharmaceutical claims, hospitalisation, and death registration databases. People with T1DM enrolled in DCSS between 1994-2018 were included. All-cause, premature, and cardiovascular mortalities were estimated by Poisson regression models with adjustment for population-level confounders. The mortality rates ratio (MRR) was standardized against the DCSS type 2 diabetes population. Mortality rates were compared by ethnic group (NZ European (NZE) and non-NZE) and socioeconomic deprivation quintile. The population attributable fraction (PAF) was estimated for ethnic and socioeconomic disparities by Cox regression adjusting for demographic, lifestyle, and clinical covariates. The adjusted slope index inequality (SII) and relative index of inequality (RII) were used to measure the socioeconomic disparity in mortalities.
Results: Overall, 2395 people with T1DM (median age 34.6 years; 45% female; 69% NZE) were enrolled, among whom the all-cause, premature and CVD mortalities were 6.69 (95% confidence interval: 5.93-7.53), 3.30 (2.77-3.90) and 1.77 (1.39-2.23) per 1,000 person-years over 25 years. The overall MRR was 0.39 (0.34-0.45), 0.65 (0.52-0.80), and 0.31 (0.24-0.41) for all-cause, premature and CVD mortality, respectively. PAF attributable to ethnicity disparity was not significantly different for mortality. The adjusted PAF indicated that 25.74 (0.84-44.39)% of all-cause mortality, 25.88 (0.69-44.69)% of premature mortality, 55.89 (1.20-80.31)% of CVD mortality could be attributed to socioeconomic inequality. The SII was 8.04 (6.30-9.78), 4.81 (3.60-6.02), 2.70 (1.82-3.59) per 1,000 person-years and RII was 2.20 (1.94-2.46), 2.46 (2.09-2.82), and 2.53 (2.03-3.03) for all-cause, premature and CVD mortality, respectively.
Conclusions: Our results suggest that socioeconomic disparities were responsible for a substantial proportion of all-cause, premature and CVD mortality in people with T1DM in Auckland, NZ. Reducing socioeconomic barriers to management and self-management would likely improve clinical outcomes.
(© 2024. The Author(s).)
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فهرسة مساهمة: Keywords: Ethnic disparity; Mortality; New Zealand; Population attributable risk; Socioeconomic disparity; Standardised mortality ratio; Type 1 diabetes
تواريخ الأحداث: Date Created: 20240125 Date Completed: 20240130 Latest Revision: 20240209
رمز التحديث: 20240210
مُعرف محوري في PubMed: PMC10811898
DOI: 10.1186/s12889-023-17326-8
PMID: 38273238
قاعدة البيانات: MEDLINE
الوصف
تدمد:1471-2458
DOI:10.1186/s12889-023-17326-8