Study Common Diabetes in Poverty Regions

Diabetes and obesity are more common in poorer neighborhoods

03/03/2014

A telephone health survey has found that people living in poorer neighborhoods are more likely to be affected by type 2 diabetes and obesity. This applies also to those persons who are well.

Disease risk regardless of individual social status
People living in a disadvantaged region in Germany are at increased risk for type 2 diabetes and obesity. The risk of disease is also increased for those living there, regardless of their individual social status. This is based on a recent analysis of data from the telephone health survey GEDA („Health in Germany currently“) of the Robert Koch Institute (RKI). The results of the scientists from the Institute for Health Economics and Management in Health Care (IGM) at the Helmholtz Zentrum München (HMGU) and the Department of Epidemiology and Health Monitoring at the RKI in Berlin were published a few days ago in the journal „PLOS ONE“ released.

Factors such as income or unemployment can affect all residents
As first author Werner Maier explained, regional factors such as the average income of the population, unemployment or the nature of the living environment could affect all residents health-related, regardless of the educational status of the individuals themselves. The authors' group evaluated data from more than 33,000 people over the age of 30 who had participated in the telephone health surveys GEDA in 2009 and 2010. As reported by the institutions, people living in socio-economically disadvantaged regions have an above-average incidence of diabetes mellitus and obesity (obesity).

Individual risk factors were included
As „regional deprivation“ designated geographic disadvantage was calculated using the „German Index of Multiple Deprivation“ (GIMD) determines which information is made available on a regional basis from income, employment, education, municipal income, social capital, environment and security in a defined area. The individual regions were anonymised and individual risk factors such as age, gender, body mass index, smoking, physical activity, education and life in a partnership were also included in the analysis. The researchers found that in the regions with the highest deprivation category, the incidence of type 2 diabetes was 8.6 percent of respondents and 16.9 percent for obesity. In the only slightly deprived regions, this was only 5.8 percent and 13.7 percent, respectively.

Differences between men and women
The results were screened for relevant differences in all individual factors and thus individuals in the most deprived areas were still about 20 percent more likely to have type 2 diabetes compared to men and women in the least favored regions. This risk was even increased by almost 30 percent in obesity. Particularly in women, high regional deprivation was an independent factor influencing diabetes and obesity. In contrast, in men, a statistically significant and independent association was found for obesity, but not for diabetes.

Previous investigations were unsatisfactory
As the researchers said, previous research on regional factors related to diabetes and obesity has been unsatisfactory. „Our findings point to the importance of regional factors in connection with common health problems such as diabetes mellitus and obesity in Germany“, so Dr. Andreas Mielck from HMGU, „Previous studies have often been falsified by their individual socioeconomic status or have used only regionally limited or non-German data.“ Werner Maier added in the message: „Spatial risk factors such as material and social deprivation are an important starting point for developing region-specific, effective prevention measures.“

Federal ministries promote the research network
According to the results of nationwide health monitoring, six million people over the age of 18 are affected by diabetes mellitus across Germany, and obesity even affects more than twice as many adults. The epidemiological analyzes were carried out as part of a cooperation project of both institutions on diabetes mellitus and social inequality in the Competence Network Diabetes Mellitus. Both institutions are funded within this research network by the Federal Ministry of Education and Research. The GEDA data collections are carried out regularly as part of nationwide health monitoring at the RKI with funding from the Federal Ministry of Health. (Sb)

Picture: angieconscious