Gender-specific trends of educational inequality in diagnosed diabetes from 1999 to 2014 in Hong Kong: a serial cross-sectional study of 97,481 community-dwelling Chinese adults.

IF 3.2 2区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Population Health Metrics Pub Date : 2021-10-10 DOI:10.1186/s12963-021-00268-x

Gary Ka-Ki Chung, Francisco Tsz Tsun Lai, Eng-Kiong Yeoh, Roger Yat-Nork Chung

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引用次数: 5

Abstract

Background: Gender differences in the trend of educational inequality in diabetes have been widely observed in the Western populations, indicating the increasing importance of educational attainment as a social determinant of diabetes among women. Nonetheless, relevant evidence is scarce in developed Asian settings for comparisons. This study examined the gender-specific trends of educational inequality in diagnosed diabetes in Hong Kong between 1999 and 2014.

Methods: A series of eight territory-wide population-representative samples of 97,481 community-dwelling Hong Kong Chinese adults aged 45 or above were surveyed between 1999 and 2014. Regression-based Relative Index of Inequality (RII) and age-standardized Slope Index of Inequality (SII) were adopted to examine the extent and trend of gender-specific educational inequality in self-reported physician-diagnosed diabetes.

Results: Age-standardized prevalence of diabetes increased in both genders over time, with a steeper surge among men. In addition, educational inequalities in diabetes, in both relative and absolute terms, significantly widened among women over the study period (annual RII change = 1.04; 95% CI = 1.02-1.07, annual SII change = 0.36%; 95% CI = 0.16-0.56%), with the peak in 2011 (RII = 2.44; 95% CI = 1.83-3.24, SII = 9.21%; 95% CI = 6.47-11.96%). However, no significant widening inequality was found among men. Further adjustment for household income level did not attenuate the observed educational inequality.

Conclusions: Despite a greater increase in diabetes prevalence among men, disparity in diabetes substantially widened across education levels among women in the past decade in Hong Kong. The gender perspective should be taken into considerations for policy making to alleviate the prevalence surge and rising educational inequality in diabetes.

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1999 - 2014年香港糖尿病患者教育不平等的性别差异趋势:一项对97,481名居住在社区的中国成年人的连续横断面研究

背景:在西方人群中，糖尿病教育不平等趋势的性别差异已经被广泛观察到，这表明教育程度作为女性糖尿病的社会决定因素越来越重要。然而，在亚洲发达国家，相关的比较证据很少。本研究调查了1999年至2014年间香港糖尿病患者受教育程度不平等的性别趋势。方法:在1999年至2014年期间，对97,481名45岁或以上的香港华人社区居民进行了一系列具有全港人口代表性的调查。采用基于回归的相对不平等指数(RII)和年龄标准化的不平等斜率指数(SII)来检验自述医师诊断糖尿病中性别教育不平等的程度和趋势。结果:随着时间的推移，年龄标准化的糖尿病患病率在两性中都有所增加，其中男性的激增幅度更大。此外，在研究期间，糖尿病的教育不平等，无论是相对的还是绝对的，都在女性中显著扩大(年度RII变化= 1.04;95% CI = 1.02-1.07, SII年变化= 0.36%;95% CI = 0.16-0.56%)，峰值出现在2011年(RII = 2.44;95% ci = 1.83 ~ 3.24, sii = 9.21%;95% ci = 6.47-11.96%)。然而，在男性中没有发现明显的不平等扩大。进一步调整家庭收入水平并没有减弱观察到的教育不平等。结论:在过去十年中，尽管香港男性糖尿病患病率增加较多，但女性在糖尿病患病率上的差异在教育水平上明显扩大。在制定政策时应考虑到性别观点，以缓解糖尿病患病率激增和教育不平等的加剧。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Population Health Metrics PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

0.00%

发文量

审稿时长

29 weeks

期刊介绍： Population Health Metrics aims to advance the science of population health assessment, and welcomes papers relating to concepts, methods, ethics, applications, and summary measures of population health. The journal provides a unique platform for population health researchers to share their findings with the global community. We seek research that addresses the communication of population health measures and policy implications to stakeholders; this includes papers related to burden estimation and risk assessment, and research addressing population health across the full range of development. Population Health Metrics covers a broad range of topics encompassing health state measurement and valuation, summary measures of population health, descriptive epidemiology at the population level, burden of disease and injury analysis, disease and risk factor modeling for populations, and comparative assessment of risks to health at the population level. The journal is also interested in how to use and communicate indicators of population health to reduce disease burden, and the approaches for translating from indicators of population health to health-advancing actions. As a cross-cutting topic of importance, we are particularly interested in inequalities in population health and their measurement.