The interaction between district-level development and individual-level socioeconomic gradients of cardiovascular disease risk factors in India

• Verfasst von: Jung, Lara [VerfasserIn]
• Verfasst von: De Neve, Jan-Walter [VerfasserIn]
• Verfasst von: Chen, Simiao [VerfasserIn]
• Verfasst von: Manne-Goehler, Jennifer [VerfasserIn]
• Verfasst von: Jaacks, Lindsay M. [VerfasserIn]
• Verfasst von: Corsi, Daniel J. [VerfasserIn]
• Verfasst von: Awasthi, Ashish [VerfasserIn]
• Verfasst von: Subramanian, S. V. [VerfasserIn]
• Verfasst von: Vollmer, Sebastian [VerfasserIn]
• Verfasst von: Bärnighausen, Till [VerfasserIn]
• Verfasst von: Geldsetzer, Pascal [VerfasserIn]
• Titel: The interaction between district-level development and individual-level socioeconomic gradients of cardiovascular disease risk factors in India
• Titelzusatz: a cross-sectional study of 2.4 million adults
• Verf.angabe: Lara Jung, Jan-Walter De Neve, Simiao Chen, Jennifer Manne-Goehler, Lindsay M. Jaacks, Daniel J. Corsi, Ashish Awasthi, S.V. Subramanian, Sebastian Vollmer, Till Bärnighausen, Pascal Geldsetzer
• Jahr: 2019
• Umfang: 13 S.
• Fussnoten: Gesehen am 24.04.2020
• Titel Quelle: Enthalten in: Social science & medicine
• Ort Quelle: Amsterdam [u.a.] : Elsevier Science, 1967
• Jahr Quelle: 2019
• Band/Heft Quelle: 239(2019) Artikel-Nummer 112514, 13 Seiten
• ISSN Quelle: 1873-5347
• DOI: doi:10.1016/j.socscimed.2019.112514
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Cardiovascular disease
• Sach-SW: Diabetes mellitus
• Sach-SW: Economic development
• Sach-SW: Hypertension
• Sach-SW: India
• Sach-SW: Multi-level modeling
• Sach-SW: Obesity
• Sach-SW: Smoking
• K10plus-PPN: 1696033470

Abstract

Background - Diabetes, hypertension, and obesity tend to be positively associated with socio-economic status in low- and middle-income countries (LMICs). It has been hypothesized that these positive socio-economic gradients will reverse as LMICs continue to undergo economic development. We use population-based cross-sectional data in India to examine how a district's economic development is associated with socio-economic differences in cardiovascular disease (CVD) risk factor prevalence between individuals. - Methods - We separately analyzed two nationally representative household survey datasets - the NFHS-4 and the DLHS-4/AHS - that are representative at the district level in India. Diabetes was defined based on a capillary blood glucose measurement, hypertension on blood pressure measurements, obesity on measurements of height and weight, and current smoking on self-report. Five different measures of a district's economic development were used. We analyzed the data using district-level regressions (plotting the coefficient comparing high to low socio-economic status against district-level economic development) and multilevel modeling. - Results - 757,655 and 1,618,844 adults participated in the NFHS-4 and DLHS-4/AHS, respectively. Higher education and household wealth were associated with a higher probability of having diabetes, hypertension, and obesity, and a lower probability of being a current smoker. For diabetes, hypertension, and obesity, we found that a higher economic development of a district was associated with a less positive (or even negative) association between the CVD risk factor and education. For smoking, the association with education tended to become less negative as districts had a higher level of economic development. In general, these associations did not show clear trends when household wealth quintile was used as the measure of socio-economic status instead of education. - Conclusions - While this study provides some evidence for the “reversal hypothesis”, large-scale longitudinal studies are needed to determine whether LMICs should expect a likely reversal of current positive socioeconomic gradients in diabetes, hypertension, and obesity as their countries continue to develop economically.