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. 2011 Feb;101(2):294-301.
doi: 10.2105/AJPH.2009.190165. Epub 2010 Dec 16.

Socioeconomic gradients in chronic disease risk factors in middle-income countries: evidence of effect modification by urbanicity in Argentina

Nancy L Fleischer  1 , Ana V Diez Roux, Marcio Alazraqui, Hugo Spinelli, Fernando De Maio
Affiliations

Socioeconomic gradients in chronic disease risk factors in middle-income countries: evidence of effect modification by urbanicity in Argentina

Nancy L Fleischer et al. Am J Public Health. 2011 Feb.

Abstract

Objectives: We investigated associations of socioeconomic position (SEP) with chronic disease risk factors, and heterogeneity in this patterning by provincial-level urbanicity in Argentina.

Methods: We used generalized estimating equations to determine the relationship between SEP and body mass index, high blood pressure, diabetes, low physical activity, and eating fruit and vegetables, and examined heterogeneity by urbanicity with nationally representative, cross-sectional survey data from 2005. All estimates were age adjusted and gender stratified.

Results: Among men living in less urban areas, higher education was either not associated with the risk factors or associated adversely. In more urban areas, higher education was associated with better risk factor profiles (P < .05 for 4 of 5 risk factors). Among women, higher education was associated with better risk factor profiles in all areas and more strongly in more urban than in less urban areas (P < 0.05 for 3 risk factors). Diet (in men) and physical activity (in men and women) were exceptions to this trend.

Conclusions: These results provide evidence for the increased burden of chronic disease risk among those of lower SEP, especially in urban areas.

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Figures

FIGURE 1
FIGURE 1
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among men, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 1
FIGURE 1
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among men, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 1
FIGURE 1
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among men, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 1
FIGURE 1
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among men, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 1
FIGURE 1
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among men, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 2
FIGURE 2
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among women, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 2
FIGURE 2
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among women, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 2
FIGURE 2
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among women, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 2
FIGURE 2
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among women, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
FIGURE 2
FIGURE 2
Predicted mean BMI and probability of hypertension, diabetes, low physical activity, and eating fruit and vegetables among women, by education according to different levels of urbanicity: National Survey of Risk Factors for Noncommunicable Diseases, Argentina, 2005. Note. BMI = body mass index.
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