Educational Disparities in Distribution of Cardiovascular Risk Factors and Quality of Care in Korean Adults: Korean National Health and Nutrition Survey IV
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: The purpose of this study was to investigate how educational status influences cardiovascular risk factors and care of diabetes mellitus and hypertension. Methods: From Korean National Health and Nutrition Survey IV, we obtained survey results of 6,835 men and 9,067 women more than 30 years old. We performed multivariate logistic regression to compare cardiovascular risk factors and care of hypertension and diabetes respective to educational status. Results: There were disparities in cardiovascular risk factors by educational status. In men, impaired fasting glucose, high triglyceride, and smoking were less frequently found in the highest educated group than in the middle educated group. In women, the prevalence of abdominal obesity, impaired fasting glucose, high blood pressure, high triglyceride, and metabolic syndrome among the highest educated group were significantly lower. The proportion of those with proper physical activity in the highest educated group was found to be less than that of the middle educated group, regardless of gender. For care of diabetes mellitus and hypertension, disease recognition and treatment were lower among the lowest educated group in men, while these disparities were not shown in women. Instead, the lowest educated group in diabetic women received screening exams for eye and kidney complications less than the middle education group. In both genders, the high education group had a higher chance of receiving education about diabetes mellitus. Conclusion: There were educational disparities in cardiovascular risk factors and care of hypertension and diabetes mellitus. The disparities were found to be different by gender.
Abstract
Background: The purpose of this study was to investigate how educational status influences cardiovascular risk factors and care of diabetes mellitus and hypertension. Methods: From Korean National Health and Nutrition Survey IV, we obtained survey results of 6,835 men and 9,067 women more than 30 years old. We performed multivariate logistic regression to compare cardiovascular risk factors and care of hypertension and diabetes respective to educational status. Results: There were disparities in cardiovascular risk factors by educational status. In men, impaired fasting glucose, high triglyceride, and smoking were less frequently found in the highest educated group than in the middle educated group. In women, the prevalence of abdominal obesity, impaired fasting glucose, high blood pressure, high triglyceride, and metabolic syndrome among the highest educated group were significantly lower. The proportion of those with proper physical activity in the highest educated group was found to be less than that of the middle educated group, regardless of gender. For care of diabetes mellitus and hypertension, disease recognition and treatment were lower among the lowest educated group in men, while these disparities were not shown in women. Instead, the lowest educated group in diabetic women received screening exams for eye and kidney complications less than the middle education group. In both genders, the high education group had a higher chance of receiving education about diabetes mellitus. Conclusion: There were educational disparities in cardiovascular risk factors and care of hypertension and diabetes mellitus. The disparities were found to be different by gender.
참고문헌 (27)
- Austin MA, "Hypertriglyceridemia as a cardiovascular risk factor", Am J Cardiol, 81, pp.7B~12B (1998)
- Berenson GS, "Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults", The Bogalusa Heart Study. N Engl J Med, 338, pp.1650~1656 (1998)
- Kannel WB, "Diabetes and cardiovascular risk factors: the Framingham study", Circulation, 59, pp.8~13 (1979)
- Lindsay RS, "Cardiovascular risk associated with the metabolic syndrome", Curr Diab Rep, 4, pp.62~68 (2004)
- Wilson PW, "Established risk factors and coronary artery disease: the Framingham Study", Am J Hypertens, 7(7 Pt 2), pp.7S~12S (1994)
- "Life table by the cause of death in 2009"[URL]
- DeSantis C, "Disparities in breast cancer prognostic factors by race, insurance status, and education", Cancer Causes Control, 21, pp.1445~1450 (2010)
- Icli F, "Education, economic status and other risk factors in gastric cancer: “a case-control study of Turkish Oncology Group”", Med Oncol, 28, pp.112~120 (2011)
- Kurzinger ML, "Education status among orphans and non-orphans in communities affected by AIDS in Tanzania and Burkina Faso", AIDS Care, 20, pp.726~732 (2008)
- Tavani A, "Education, socioeconomic status and risk of cancer of the colon and rectum", Int J Epidemiol, 28, pp.380~385 (1999)
- Gupta R, "Cardiovascular risk according to educational status in India", Prev Med, 51, pp.408~411 (2010)
- Reddy KS, "Educational status and cardiovascular risk profile in Indians", Proc Natl Acad Sci U S A, 104, pp.16263~16268 (2007)
- Grundy SM, "Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute", American Heart Association conference on scientific issues related to definition, 2004, pp.24, e13~e18
- Lee SY, "Appropriate waist circumference cutoff points for central obesity in Korean adults", DIABETES RES CLIN PRACT, 75(1), pp.72~80 (2007), ELSEVIER IRELAND LTD
- "Physical activity guidelines for Americans" (2008)[URL]
- American Diabetes Association, "Standards of medical care in diabetes--2011", Diabetes Care, 34, pp.S11~S61 (2011)
- The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure, "Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure", National Heart, Lung, and Blood Institute, ~, pp.NIH publication, no. 04-5230 (2004)
- Kaplan GA, "Socioeconomic factors and cardiovascular disease: a review of the literature", Circulation, 88(4 Pt 1), pp.1973~1998 (1993)
- Popham F, "Relation of employment status to socioeconomic position and physical activity types", Prev Med, 45, pp.182~188 (2007)
- "Economically active population by educational status from 2010 July to 2011 July"[URL]
- Kershaw KN, "Socioeconomic position, health behaviors, and C-reactive protein: a moderated-mediation analysis", Health Psychol, 29, pp.307~316 (2010)
- Bosma H, "Disparities by education level in outcomes of a self-management intervention: the DELTA trial in The Netherlands", Psychiatr Serv, 62, pp.793~795 (2011)
- Ayyagari P, "Education and health: evidence on adults with diabetes", Int J Health Care Finance Econ, 11, pp.35~54 (2011)
- Redon J, "Physician attitudes to blood pressure control: findings from the Supporting Hypertension Awareness and Research Europe-wide survey", J Hypertens, 29, pp.1633~1640 (2011)
- Turchin A, "The doctor needs to see you now: accelerating the care of patients with uncontrolled hypertension", Expert Rev Cardiovasc Ther, 8, pp.1501~1503 (2010)
- Kandula NR, "Knowledge gaps and misconceptions about coronary heart disease among U.S. South Asians", Am J Prev Med, 38, pp.439~442 (2010)
- Malyutina S, "Education, marital status, and total and cardiovascular mortality in Novosibirsk, Russia: a prospective cohort study", Ann Epidemiol, 14, pp.244~249 (2004)
