Abstract
OBJECTIVE: To study the association between neighbourhood socioeconomic status and diabetes prevalence, incidence, and control in the entire population of northeastern Madrid, Spain.
SETTING: Electronic health records of the primary-care system in four districts of Madrid (Spain).
PARTICIPANTS: 269 942 people aged 40 or older, followed from 2013 to 2014.
EXPOSURE: Neighbourhoodsocioeconomic status (NSES), measured using a composite index of seven indicators from four domains of education, wealth, occupation and living conditions.
PRIMARY OUTCOME MEASURES: Diagnosis of diabetes based on ICPC-2 codes and glycated haemoglobin (HbA1c %).
RESULTS: In regression analyses adjusted by age and sex and compared with individuals living in low NSES neighbourhoods, men living in medium and high NSES neighbourhoods had 10% (95% CI: 6% to 15%) and 29% (95% CI: 25% to 32%) lower prevalence of diabetes, while women had 27% (95% CI: 23% to 30%) and 50% (95% CI: 47% to 52%) lower prevalence of diabetes. Moreover, the hazard of diabetes in men living in medium and high NSES neighbourhoods was 13% (95% CI: 1% to 23%) and 20% (95% CI: 9% to 29%) lower, while the hazard of diabetes in women living in medium and high NSES neighbourhoods was 17% (95% CI: 3% to 29%) and 31% (95% CI: 20% to 41%) lower. Individuals living in medium and high SES neighbourhoods had 8% (95% CI: 2% to 15%) and 15% (95% CI: 9% to 21%) lower prevalence of lack of diabetes control, and a decrease in average HbA1c % of 0.05 (95% CI: 0.01 to 0.10) and 0.11 (95% CI: 0.06 to 0.15).
CONCLUSIONS: Diabetes prevalence, incidence and lack of control increased with decreasing NSES in a southern European city. Future studies should provide mechanistic insights and targets for intervention to address this health inequity.
| Original language | English (US) |
|---|---|
| Pages (from-to) | e021143 |
| Journal | BMJ Open |
| Volume | 8 |
| Issue number | 9 |
| DOIs | |
| State | Published - Oct 4 2018 |
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Keywords
- diabetes
- neighborhoods
- record linkage
- social epidemiology
- social inequalities
- spain
ASJC Scopus subject areas
- Medicine(all)
Cite this
Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain) : the HeartHealthyHoods study. / Bilal, Usama; Hill-Briggs, Felicia; Sánchez-Perruca, Luis; Del Cura-González, Isabel; Franco, Manuel.
In: BMJ Open, Vol. 8, No. 9, 04.10.2018, p. e021143.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Association of neighbourhood socioeconomic status and diabetes burden using electronic health records in Madrid (Spain)
T2 - the HeartHealthyHoods study
AU - Bilal, Usama
AU - Hill-Briggs, Felicia
AU - Sánchez-Perruca, Luis
AU - Del Cura-González, Isabel
AU - Franco, Manuel
PY - 2018/10/4
Y1 - 2018/10/4
N2 - OBJECTIVE: To study the association between neighbourhood socioeconomic status and diabetes prevalence, incidence, and control in the entire population of northeastern Madrid, Spain.SETTING: Electronic health records of the primary-care system in four districts of Madrid (Spain).PARTICIPANTS: 269 942 people aged 40 or older, followed from 2013 to 2014.EXPOSURE: Neighbourhoodsocioeconomic status (NSES), measured using a composite index of seven indicators from four domains of education, wealth, occupation and living conditions.PRIMARY OUTCOME MEASURES: Diagnosis of diabetes based on ICPC-2 codes and glycated haemoglobin (HbA1c %).RESULTS: In regression analyses adjusted by age and sex and compared with individuals living in low NSES neighbourhoods, men living in medium and high NSES neighbourhoods had 10% (95% CI: 6% to 15%) and 29% (95% CI: 25% to 32%) lower prevalence of diabetes, while women had 27% (95% CI: 23% to 30%) and 50% (95% CI: 47% to 52%) lower prevalence of diabetes. Moreover, the hazard of diabetes in men living in medium and high NSES neighbourhoods was 13% (95% CI: 1% to 23%) and 20% (95% CI: 9% to 29%) lower, while the hazard of diabetes in women living in medium and high NSES neighbourhoods was 17% (95% CI: 3% to 29%) and 31% (95% CI: 20% to 41%) lower. Individuals living in medium and high SES neighbourhoods had 8% (95% CI: 2% to 15%) and 15% (95% CI: 9% to 21%) lower prevalence of lack of diabetes control, and a decrease in average HbA1c % of 0.05 (95% CI: 0.01 to 0.10) and 0.11 (95% CI: 0.06 to 0.15).CONCLUSIONS: Diabetes prevalence, incidence and lack of control increased with decreasing NSES in a southern European city. Future studies should provide mechanistic insights and targets for intervention to address this health inequity.
AB - OBJECTIVE: To study the association between neighbourhood socioeconomic status and diabetes prevalence, incidence, and control in the entire population of northeastern Madrid, Spain.SETTING: Electronic health records of the primary-care system in four districts of Madrid (Spain).PARTICIPANTS: 269 942 people aged 40 or older, followed from 2013 to 2014.EXPOSURE: Neighbourhoodsocioeconomic status (NSES), measured using a composite index of seven indicators from four domains of education, wealth, occupation and living conditions.PRIMARY OUTCOME MEASURES: Diagnosis of diabetes based on ICPC-2 codes and glycated haemoglobin (HbA1c %).RESULTS: In regression analyses adjusted by age and sex and compared with individuals living in low NSES neighbourhoods, men living in medium and high NSES neighbourhoods had 10% (95% CI: 6% to 15%) and 29% (95% CI: 25% to 32%) lower prevalence of diabetes, while women had 27% (95% CI: 23% to 30%) and 50% (95% CI: 47% to 52%) lower prevalence of diabetes. Moreover, the hazard of diabetes in men living in medium and high NSES neighbourhoods was 13% (95% CI: 1% to 23%) and 20% (95% CI: 9% to 29%) lower, while the hazard of diabetes in women living in medium and high NSES neighbourhoods was 17% (95% CI: 3% to 29%) and 31% (95% CI: 20% to 41%) lower. Individuals living in medium and high SES neighbourhoods had 8% (95% CI: 2% to 15%) and 15% (95% CI: 9% to 21%) lower prevalence of lack of diabetes control, and a decrease in average HbA1c % of 0.05 (95% CI: 0.01 to 0.10) and 0.11 (95% CI: 0.06 to 0.15).CONCLUSIONS: Diabetes prevalence, incidence and lack of control increased with decreasing NSES in a southern European city. Future studies should provide mechanistic insights and targets for intervention to address this health inequity.
KW - diabetes
KW - neighborhoods
KW - record linkage
KW - social epidemiology
KW - social inequalities
KW - spain
UR - http://www.scopus.com/inward/record.url?scp=85054433096&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85054433096&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2017-021143
DO - 10.1136/bmjopen-2017-021143
M3 - Article
C2 - 30287604
AN - SCOPUS:85054433096
VL - 8
SP - e021143
JO - BMJ Open
JF - BMJ Open
SN - 2044-6055
IS - 9
ER -