Association of household wealth and education level with hypertension and diabetes among adults in Bangladesh: a propensity score‐based analysis. Issue 9 (1st June 2021)

• Record Type: Journal Article
• Authors: Gupta, Rajat Das; Chakraborty, Promit Ananyo; Hossain, Md. Belal
• Is Part Of: Tropical medicine & international health. Volume 26:Issue 9(2021)
• Page Start: 1047
• Page End: 1056
• Publication Date: 2021-06-01
• Subjects: diabetes mellitus -- hypertension -- propensity score; Tropical medicine -- Periodicals; Public health -- Periodicals; 616.988
• DOI: 10.1111/tmi.13625
• Languages: English
• ISSNs: 1360-2276

Abstract

Abstract: Objective: To determine the association of household wealth and education level with hypertension and diabetes in Bangladesh using propensity score (PS) analyses. Methods: A nationally representative sample of the Bangladesh Demographic and Health Survey 2017–18 was analysed to explore the research question. A weighted sample of 11 320 individuals was considered. Hypertension and diabetes were the outcomes of interest, and household wealth status (non‐poor and poor) and education level (secondary/higher education and no secondary/higher education) were the exposure variables of interest. A person was defined as hypertensive if their average blood pressure was ≥140/90 mmHg or self‐reported history of taking antihypertensive medications. Individuals were classified as diabetic if they had a Fasting Blood Glucose level of ≥7 mmol/l or reported taking prescribed medication for reducing high blood glucose or diabetes. We used the 1:1 nearest neighbour PS matching without replacement and PS weighting approaches to assess the association between the exposures and the outcome variables. Results: Wealth status was significantly associated with diabetes but not with hypertension, while education status was significantly associated with neither diabetes nor hypertension. We also observed a significant interaction effect between household wealth status and education level with diabetes. The odds of diabetes were approximately 60% higher among adults from non‐poor households and those without secondary/higher education. Conclusion: Diabetes prevention and control programs should focus on non‐poor individuals, while hypertension prevention programs should target populations irrespective of educational attainment and wealth status.