Association of education level with diabetes prevalence in Latin American cities and its modification by city social environment
| العنوان: | Association of education level with diabetes prevalence in Latin American cities and its modification by city social environment |
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| المؤلفون: | Diego I. Lucumi, Philipp Hessel, Francisco Diez-Canseco, Brent A. Langellier, Lorena Rodríguez Osiac, Maria F Kroker, Ana V. Diez Roux, Ariela Braverman-Bronstein, Andrés Trotta, Catalina González-Uribe |
| المصدر: | Journal of Epidemiology and Community Health |
| بيانات النشر: | BMJ, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Male, Latin Americans, Inequality, Epidemiology, media_common.quotation_subject, 030209 endocrinology & metabolism, Social Environment, 03 medical and health sciences, 0302 clinical medicine, Urbanization, Diabetes Mellitus, Prevalence, Humans, Medicine, Social inequality, 030212 general & internal medicine, Cities, Socioeconomics, Socioeconomic status, Original Research, media_common, education, urbanisation, diabetes, social inequalities, business.industry, Multilevel model, 1. No poverty, Public Health, Environmental and Occupational Health, Social environment, Educational attainment, 3. Good health, Latin America, Socioeconomic Factors, epidemiology, Female, business |
| الوصف: | BackgroundDiabetes prevalence continues to increase in urban areas of low-income and middle-income countries (LMIC). Evidence from high-income countries suggests an inverse association between educational attainment and diabetes, but research in LMIC is limited. We investigated educational differences in diabetes prevalence across 232 Latin American (LA) cities, and the extent to which these inequities vary across countries/cities and are modified by city socioeconomic factors.MethodsUsing harmonised health survey and census data for 110 498 city dwellers from eight LA countries, we estimated the association between education and diabetes. We considered effect modification by city Social Environment Index (SEI) as a proxy for city-level development using multilevel models, considering heterogeneity by sex and country.ResultsIn women, there was an inverse dose–response relationship between education and diabetes (OR: 0.80 per level increase in education, 95% CI 0.75 to 0.85), consistent across countries and not modified by SEI. In men, Argentina, Brazil, Colombia, Chile and Mexico showed an inverse association (pooled OR: 0.92; 95% CI 0.86 to 0.99). Peru, Panama and El Salvador showed a positive relationship (pooled OR 1.24; 95% CI 1.04 to 1.49). For men, these associations were further modified by city-SEI: in countries with an inverse association, it became stronger as city-SEI increased. In countries where the association was positive, it became weaker as city-SEI increased.ConclusionSocial inequities in diabetes inequalities increase as cities develop. To achieve non-communicable disease-related sustainable development goals in LMIC, there is an urgent need to develop policies aimed at reducing these educational inequities. |
| تدمد: | 1470-2738 0143-005X |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ff84006ba9a2a94d75a4db0b5ea1bf80 https://doi.org/10.1136/jech-2020-216116 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....ff84006ba9a2a94d75a4db0b5ea1bf80 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14702738 0143005X |
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