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Socio-economic factors

Regional deprivation increases the risk of diabetes and obesity

6 million German adults are currently affected by diabetes and more than twice are obese

Living in a socioeconomically deprived region is a risk factor for being affected by diabetes and obesity, and the risk remains regardless of the individual social status of the inhabitants, according to scientists from the Institute of Health Economics and Health Care Management (IGM) at the Helmholtz Zentrum München (HMGU) and the Department of Epidemiology and Health Monitoring at the Robert Koch Institute (RKI) in Berlin, Germany. The study is published online in the journal PlosOne.

"Regional factors, such as the population's average income, unemployment or quality of the living environment can affect the health of all inhabitants, regardless of the educational level of the individual people", said the study’s lead author, Dr Werner Maier from IGM.

The researchers evaluated data from 33,690 participants aged 30 years or more who participated in the RKI's German telephone health interview surveys "German Health Update (GEDA)" in 2009 and 2010.

The outcome variables were the 12-month prevalence of known T2DM and the prevalence of obesity and the area level deprivation of the districts was defined by the German Index of Multiple Deprivation.

Results

In the most deprived regions, the frequency of type 2 diabetes was 8.6 percent among those interviewed and that of obesity was 16.9 percent, compared to 5.8 and 13.7 percent, respectively, among those interviewed in regions that are only slightly deprived. These results were reviewed to determine relevant differences in all individual factors, with the final result showing that people in the areas with the greatest deprivation still had around a 20 percent greater probability to suffer from type 2 diabetes than men and women in the least deprived regions. In the case of obesity, there was even an almost 30 percent higher probability associated with greater deprivation. For women, high regional deprivation was a particularly influential independent factor for the occurrence of diabetes and obesity. In men, it was possible to show a statistically significant and independent correlation for obesity, but not for diabetes.

"Our results point out the significance of regional factors in association with common health problems such as diabetes mellitus and obesity in Germany", said Dr.Andreas Mielck from the HMGU. "Previous investigations in this area were frequently distorted by individual socioeconomic status, or only used data from a particular region or from outside Germany."

According to the results of Germany-wide health monitoring, some six million people over the age of 18 years are currently affected by diabetes mellitus in Germany, with more than twice as many adults suffering from obesity.

“In order to reduce health disparities, diabetes and obesity prevention strategies need to consider individual as well as area-based risk factors,” the researchers concluded. “For this, it will be necessary to identify the mechanisms underlying the individual and the area level deprivation components as well as their interactions.”

To access the article, please click here

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