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Article ; Online: Trends in prevalence of obesity and its association with hypertension across socioeconomic gradients in rural Yunnan Province, China.

Wu, Xia / Li, Guohui / Liu, Lan / Zhao, Yi / Golden, Allison Rabkin / Cai, Le

2024 Volume 24, Issue 1, Page(s) 75

Abstract: Background: This study aimed to uncover the changing prevalence of obesity and its association with hypertension across socioeconomic gradients in rural southwest China.: Methods: Data were collected from two cross-sectional health interviews and ... ...

Abstract	Background: This study aimed to uncover the changing prevalence of obesity and its association with hypertension across socioeconomic gradients in rural southwest China. Methods: Data were collected from two cross-sectional health interviews and surveys from 2011 to 2021 among individuals aged ≥ 35 years in rural China. Each participant's height, weight, waist circumference, and blood pressure were measured. The overall prevalence of obesity, central obesity, and hypertension was directly standardized by age based on the total population of the two surveys. Multivariate logistic regression was used to analyze the association between obesity and prevalence of hypertension and an individual socioeconomic position (SEP) index was constructed using principal component analysis. Results: From 2011 to 2021, the prevalence of obesity, central obesity, and hypertension increased substantially, from 5.9%, 50.2%, and 26.1-12.1%, 58.0%, and 40.4% (P < 0.01), respectively. These increasing rates existed in all subcategories, including sex, age, ethnicity, education, annual household income, access to medical services, and SEP (P < 0.05). In both 2011 and 2021, lower education level and poor access to medical services correlated with higher prevalence of central obesity, while higher SEP correlated with higher prevalence of obesity and central obesity (P < 0.01). Prevalence of obesity was higher in the Han ethnicity participants and individuals with poor access to medical services than in their counterparts (P < 0.01). Whereas the prevalence of central obesity was lower in Han participants than in ethnic minority participants in 2011 (P < 0.01), this trend reversed in 2021 (P < 0.01). A positive relationship between annual household income and prevalence of obesity and central obesity was only found in 2021 (P < 0.01). Obese and centrally obese participants were more likely to be hypertensive in both survey years (P < 0.01). Conclusions: Future interventions to prevent and manage obesity in rural China should give increased attention to high income, less educated, poor access to medical services, and high SEP individuals. The implementation of these obesity interventions would also help reduce the prevalence of hypertension.
MeSH term(s)	Humans ; Obesity, Abdominal/diagnosis ; Obesity, Abdominal/epidemiology ; Ethnicity ; Prevalence ; Cross-Sectional Studies ; Minority Groups ; China/epidemiology ; Hypertension/diagnosis ; Hypertension/epidemiology ; Obesity/diagnosis ; Obesity/epidemiology ; Educational Status ; Rural Population ; Risk Factors ; Socioeconomic Factors
Language	English
Publishing date	2024-01-28
Publishing country	England
Document type	Journal Article
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-024-03741-1
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Article ; Online: Ethnic disparities in prevalence of chronic non-communicable diseases and its multimorbidity among older adults in rural southwest China.

Du, Ying-Rong / Liu, Lan / Zhao, Yi / Huang, Jing-Jing / Golden, Allison Rabkin / Cai, Le

BMC public health

2023 Volume 23, Issue 1, Page(s) 1217

Abstract: Background: As the population ages, chronic non-communicable diseases (NCDs) multimorbidity has emerged as a major public health issue globally. This study examines ethnic disparities in prevalence of NCDs and its multimorbidity among rural southwest ... ...

Abstract	Background: As the population ages, chronic non-communicable diseases (NCDs) multimorbidity has emerged as a major public health issue globally. This study examines ethnic disparities in prevalence of NCDs and its multimorbidity among rural southwest Chinese older adults. Methods: A cross-sectional survey was conducted in rural southwest population aged ≥ 60 years consisting of 5,642 consenting participants of Han and three ethnic minority groups (Dai, Ha Ni, and Bai). Information about participants' demographic characteristics and lifestyle behaviors was obtained using a standard questionnaire. Anthropometric measurements including height, weight, and waist circumference, fasting blood sugar and blood pressure measurement, as well as post-bronchodilator spirometry test were recorded for each participant. Results: The age-standardized prevalence of five common chronic NCDs- hypertension, diabetes, coronary heart disease (CHD), stroke, chronic obstructive pulmonary disease (COPD) - and its multimorbidity was 72.8%, 15.9%, 4.0%, 10.0%, 9.8%, and 27.6%, respectively. Bai participants had both the highest overall and sex-specific prevalence rates of hypertension, diabetes, stroke, and COPD, whereas Han participants had the highest rates of CHD (P < 0.01). The results of multivariate logistic regression analysis indicated that female and older participants had a higher probability of chronic NCDs multimorbidity than their counterparts (P < 0.01). Bai ethnic minority participants were more likely to have NCDs multimorbidity while Ha Ni and Dai ethnic minority participants were less likely to have NCD multimorbidity relative to the Han participants (P < 0.05). Older adults with a higher level of education and family history of chronic NCDs, and who were also current smokers, current drinkers, obese, centrally obese, and physically inactive had a greater probability of developing chronic NCDs multimorbidity (P < 0.01). Conclusions: Ethnicity and individual demographic and lifestyle factors significantly impact prevalence of chronic NCDs multimorbidity. Future chronic NCDs prevention and control strategies must be tailored to address ethnicity, and culturally tailored lifestyle interventions may reduce the prevalence of chronic NCDs multimorbidity in rural southwest China.
MeSH term(s)	Male ; Humans ; Female ; Aged ; Noncommunicable Diseases/epidemiology ; Ethnicity ; Multimorbidity ; Prevalence ; Cross-Sectional Studies ; Minority Groups ; Diabetes Mellitus/epidemiology ; Hypertension/epidemiology ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Stroke/epidemiology ; Obesity/epidemiology ; Coronary Disease ; China/epidemiology
Language	English
Publishing date	2023-06-23
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-16161-1
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Article ; Online: Socioeconomic differentials of trends in the prevalence and economic burden of chronic obstructive pulmonary disease in rural southwest China.

Cai, Le / Wang, Xu-Ming / Liu, Lan / Zhao, Yi / Golden, Allison Rabkin

BMC public health

2023 Volume 23, Issue 1, Page(s) 141

Abstract: Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity, and imposes a substantial financial burden on society. However, few studies have examined the role of individual socioeconomic status (SES) in ... ...

Abstract	Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of mortality and morbidity, and imposes a substantial financial burden on society. However, few studies have examined the role of individual socioeconomic status (SES) in temporal trends of COPD prevalence and economic cost. This study aimed to uncover the changing prevalence and economic burden of COPD across socioeconomic gradients in rural southwest China. Methods: Data were collected from two cross-sectional health interviews and examination surveys administered 10 years apart among individuals aged ≥ 35 years in rural China. A prevalence-based cost-of-illness method was used to estimate the cost of COPD. The individual socioeconomic position (SEP) index was constructed using principal component analysis. Post-bronchodilator spirometry tests were performed for each participant. Results: From 2011 to 2021, the prevalence of COPD increased from 8.7% to 12.8% (P < 0.01), while the economic cost of COPD increased 1.9-fold. Unit hospital costs and outpatient costs increased 1.57-fold and 1.47-fold, while unit medication costs fell by 10.6%. Increasing prevalence was also observed when the data were stratified by sex, age, ethnicity, level of education, level of income, and SEP (P < 0.05). Men, ethnic minorities, and those with a lower educational level, lower income, or lower SEP had a higher prevalence of COPD than their counterparts both in 2011 and 2021 (P < 0.05). Unit outpatient costs and medication costs increased with patients' SEP in both survey years (P < 0.05). Conclusions: The prevalence and economic costs of COPD increased substantially across all socioeconomic gradients in rural southwest China in the decade from 2011 and 2021. Future COPD prevention and management interventions as well as efforts to improve access to affordable COPD medication and treatment should focus in particular on ethnic minority and low SEP populations.
MeSH term(s)	Male ; Humans ; Financial Stress ; Socioeconomic Factors ; Ethnicity ; Prevalence ; Cross-Sectional Studies ; Minority Groups ; Pulmonary Disease, Chronic Obstructive/epidemiology ; China/epidemiology
Language	English
Publishing date	2023-01-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-15096-x
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Article ; Online: Rural-urban differentials of prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China.

Zhao, Yi / Li, Hui-Fang / Wu, Xia / Li, Guo-Hui / Golden, Allison Rabkin / Cai, Le

BMC public health

2023 Volume 23, Issue 1, Page(s) 603

Abstract: Background: Diabetes has become a major public health problem in China. A better understanding of diabetes determinants and urban-rural differences is essential to crafting targeted diabetes prevention measures for the elderly living in both urban and ... ...

Abstract	Background: Diabetes has become a major public health problem in China. A better understanding of diabetes determinants and urban-rural differences is essential to crafting targeted diabetes prevention measures for the elderly living in both urban and rural areas. This study aimed to compare rural-urban differentials in prevalence and lifestyle determinants of pre-diabetes and diabetes among the elderly in southwest China. Methods: A cross-sectional health interview and examination survey was conducted among individuals aged ≥ 60 years in both a rural and urban area of China. Anthropometric measurements, including height, weight, and waist circumference, as well as blood pressure and fasting blood glucose measurements were taken. Associated risk factors for pre-diabetes and diabetes were evaluated using multivariate logistic regression analysis. Results: In total, 1,624 urban residents and 1,601 rural residents consented to participate in the study. The urban prevalence of pre-diabetes and diabetes (46.8% and 24.7%, respectively), was higher than the rural prevalence (23.4% and 11.0%, respectively, P<0.01). Urban elderly participants had markedly higher prevalence of obesity, central obesity, and physical inactivity than their rural counterparts (15.3%, 76.0%, and 9.2% vs. 4.6%, 45.6%, and 6.1%, P<0.01). In contrast, rural elderly adults had higher prevalence of smoking than urban ones (23.2% vs. 17.2%, P<0.01). Obese (OR 1.71, 95% CI 1.27-2.30 vs. OR 1.73, 95% CI 1.30-3.28) and centrally obese participants (OR 1.59, 95% CI 1.18-2.15 vs. OR 1.83, 95% CI 1.32-2.54) were more likely to suffer from diabetes in both urban and rural regions. Furthermore, urban current smokers had a higher probability of suffering from diabetes (OR 1.58, 95% CI 1.11-2.25), while hypertension was positively associated with the prevalence of diabetes in the rural area (OR 2.13, 95% CI 1.54-2.95). Obese participants in the rural area were more likely to suffer from pre-diabetes (OR 2.50, 95% CI 1.53-4.08), while physical inactivity was positively associated with prevalence of pre-diabetes in the urban area (OR 1.95, 95% CI 1.37-2.80). Conclusion: Pre-diabetes and diabetes are more prevalent among urban older adults than their rural counterparts in southwest China. The identified rural-urban differentials of lifestyle factors have significant impacts on prevalence of pre-diabetes and diabetes. Thus, tailored lifestyle interventions are needed to improve diabetes prevention and management among the elderly in southwest China.
MeSH term(s)	Aged ; Humans ; Prediabetic State/epidemiology ; Prediabetic State/complications ; Prevalence ; Cross-Sectional Studies ; Diabetes Mellitus/epidemiology ; Risk Factors ; Hypertension/epidemiology ; Hypertension/etiology ; Obesity/epidemiology ; Obesity/complications ; Life Style ; China/epidemiology ; Rural Population ; Urban Population
Language	English
Publishing date	2023-03-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2041338-5
ISSN	1471-2458 ; 1471-2458
ISSN (online)	1471-2458
ISSN	1471-2458
DOI	10.1186/s12889-023-15527-9
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Article ; Online: Ethnic disparities in the prevalence of diabetes and its association with sleep disorder among older adults in rural southwest China.

Zhao, Yi / Liu, Lan / Li, Guo-Hui / Li, Hui-Fang / Wu, Xia / Golden, Allison Rabkin / Cai, Le

Ethnicity & health

2024 , Page(s) 1–12

Abstract: Objectives: This study aimed to examine ethnic disparities in the prevalence of diabetes and its association with sleep disorders among the older adults Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China.: Methods: A ... ...

Abstract	Objectives: This study aimed to examine ethnic disparities in the prevalence of diabetes and its association with sleep disorders among the older adults Han and ethnic minority (Bai, Ha Ni, and Dai) population in rural southwest China. Methods: A cross-sectional survey of 5,642 was conducted among the rural southwest population aged ≥60 years, consisting of a structured interview and measurement of fasting blood glucose, height, weight, and waist circumference. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality. Results: The overall prevalence of diabetes and sleep disorder was 10.2% and 40.1%, respectively. Bai participants had the highest prevalence of diabetes (15.9%) and obesity (9.9%)( Conclusion: There are stark ethnic disparities in the prevalence of diabetes and sleep disorders in southwest China. Future diabetes prevention and control strategies should be tailored to address ethnicity, and improving sleep quality may reduce the prevalence of diabetes.
Language	English
Publishing date	2024-04-29
Publishing country	England
Document type	Journal Article
ZDB-ID	1497968-8
ISSN	1465-3419 ; 1355-7858
ISSN (online)	1465-3419
ISSN	1355-7858
DOI	10.1080/13557858.2024.2346252
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Article ; Online: The Scholarly and Pedagogical Benefits of the Legal Laboratory: Lessons from the Consortium for the Advanced Study of Brain Injury at Yale Law School.

Shapiro, Zachary E / Deb, Chaarushena / Lawrence, Caroline / Golden, Allison Rabkin / Wright, Megan S / Kraschel, Katherine L / Fins, Joseph J

The Journal of law, medicine & ethics : a journal of the American Society of Law, Medicine & Ethics

2023 Volume 51, Issue 3, Page(s) 672–683

Abstract: In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents ...

Abstract	In our article, we share the lessons we have learned after creating and running a successful legal laboratory over the past seven years at Yale Law School. Our legal laboratory, which focuses on the intersection of law and severe brain injury, represents a unique pedagogical model for legal academia, and is closely influenced by the biomedical laboratory.
MeSH term(s)	Humans ; Schools ; Brain Injuries
Language	English
Publishing date	2023-12-13
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1168812-9
ISSN	1748-720X ; 1073-1105 ; 0277-8459
ISSN (online)	1748-720X
ISSN	1073-1105 ; 0277-8459
DOI	10.1017/jme.2023.126
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Article ; Online: Short-Term Trends in Economic Burden and Catastrophic Costs of Type 2 Diabetes Mellitus in Rural Southwest China.

Li, Hui-Fang / Cai, Le / Golden, Allison Rabkin

Journal of diabetes research

2019 Volume 2019, Page(s) 9626413

Abstract: Objectives: This study is aimed at gaining insights on the changing prevalence, economic burden, and catastrophic costs of diabetes in rural southwest China.: Materials and methods: Data were collected from two cross-sectional health interviews and ... ...

Abstract	Objectives: This study is aimed at gaining insights on the changing prevalence, economic burden, and catastrophic costs of diabetes in rural southwest China. Materials and methods: Data were collected from two cross-sectional health interviews and examination surveys among individuals aged ≥ 35 years in rural Yunnan Province. A prevalence-based cost-of-illness method was used to estimate the cost of diabetes. Information about the participants' demographic characteristics and economic consequences of diabetes was obtained using a standard questionnaire. Fasting blood sugar levels were recorded for each study participant. Results: During the study period, the overall prevalence of diabetes increased from 7.7% to 9.5% ( Conclusions: The prevalence and economic burden of diabetes increased substantially from 2009 to 2016 in rural southwest China. The findings underscore an urgent need for the government to invest more financial resources in the prevention of diabetes and improvement of access to affordable medication in rural southwest China.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; China/epidemiology ; Cost of Illness ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2/economics ; Diabetes Mellitus, Type 2/epidemiology ; Diabetes Mellitus, Type 2/therapy ; Female ; Health Expenditures/trends ; Humans ; Male ; Middle Aged ; Prevalence ; Rural Health/economics ; Rural Health/statistics & numerical data ; Rural Health/trends ; Rural Population/statistics & numerical data ; Socioeconomic Factors ; Surveys and Questionnaires
Language	English
Publishing date	2019-08-01
Publishing country	England
Document type	Journal Article
ZDB-ID	2711897-6
ISSN	2314-6753 ; 2314-6753
ISSN (online)	2314-6753
ISSN	2314-6753
DOI	10.1155/2019/9626413
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Article ; Online: Ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China: a cross-sectional study.

Wang, Xu-Ming / Wu, Chao / Golden, Allison Rabkin / Le, Cai

BMJ open

2019 Volume 9, Issue 9, Page(s) e028770

Abstract: Objectives: This study examines ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China.: Design: This was a cross-sectional design.: Setting: This study was conducted in rural Yunnan Province of ... ...

Abstract	Objectives: This study examines ethnic disparities in prevalence and patterns of smoking and nicotine dependence in rural southwest China. Design: This was a cross-sectional design. Setting: This study was conducted in rural Yunnan Province of China. Participants: 7027 consenting individuals aged ≥35 years among Han majority and four ethnic minority groups (Na Xi, Li Shu, Dai and Jing Po) participated in this study. Information about participants' demographic characteristics as well as smoking habits and an assessment of nicotine dependence with the Fagerstrom Test for Nicotine Dependence (FTND) was obtained using a standard questionnaire. Results: Males had significantly higher prevalence of current smoking than females (64.8% and 44.4%, p<0.01). Among current smokers, the prevalence of nicotine dependence was significantly higher in males compared with females (19.9% and 7.1%, p<0.01). Jing Po men and women had the highest prevalence of current smokers (72.2% vs 23.1%, p<0.01), whereas the highest prevalence of nicotine dependence was found in male Dai current smokers and female Li Shu current smokers (44.8% vs 32.5%, p<0.01). Filtered cigarettes were the most popular form of tobacco used across all five ethnic groups. Over 75% of tobacco users initiated smoking and regularly smoked during adolescence, and those of minority ethnicity smoked regularly at a younger age than those of Han descent (p<0.05). Individuals in all five ethnic groups with higher levels of education had a lower probability of current smoking status (p<0.05), whereas a negative association of level of education with nicotine dependence was only observed in current smokers in the Han majority and Dai ethnic minority groups. Among Han majority current smokers, higher annual household income was associated with a higher risk of nicotine dependence (p<0.05). Conclusion: Future interventions to control tobacco use should be tailored to address ethnicity and socioeconomic factors.
MeSH term(s)	Adult ; China/epidemiology ; Cigarette Smoking/epidemiology ; Cigarette Smoking/ethnology ; Cross-Sectional Studies ; Ethnic Groups/statistics & numerical data ; Female ; Humans ; Male ; Middle Aged ; Minority Groups/statistics & numerical data ; Pipe Smoking/epidemiology ; Pipe Smoking/ethnology ; Prevalence ; Social Class ; Tobacco Use/epidemiology ; Tobacco Use/ethnology ; Tobacco Use Disorder/epidemiology ; Tobacco Use Disorder/ethnology ; Tobacco, Smokeless ; Water Pipe Smoking/epidemiology ; Water Pipe Smoking/ethnology
Language	English
Publishing date	2019-09-20
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2747269-3
ISSN	2044-6055 ; 2044-6055 ; 2053-3624
ISSN (online)	2044-6055
ISSN	2044-6055 ; 2053-3624
DOI	10.1136/bmjopen-2018-028770
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Article ; Online: Ethnic disparities in prevalence and clustering of cardiovascular disease risk factors in rural Southwest China.

Hui-Fang, Li / Cai, Le / Wang, Xu-Ming / Golden, Allison Rabkin

BMC cardiovascular disorders

2019 Volume 19, Issue 1, Page(s) 200

Abstract: Background: This study examines how prevalence and clustering of cardiovascular disease (CVD) risk factors differ by ethnicity and socioeconomic status (SES) among rural southwest Chinese adults.: Methods: A cross-sectional survey of 7027 adults aged ...

Abstract	Background: This study examines how prevalence and clustering of cardiovascular disease (CVD) risk factors differ by ethnicity and socioeconomic status (SES) among rural southwest Chinese adults. Methods: A cross-sectional survey of 7027 adults aged ≥35 years of Han and four ethnic minority group descent (Na Xi, Li Shu, Dai, and Jing Po) was used to derive prevalence of tobacco smoking and exposure to secondhand smoke (SHS) as well as alcohol consumption and physical activity data. Anthropometric measurements were also taken, including height, weight, and waist and hip circumference, as well as blood pressure (BP) and fasting blood glucose (FBG) measurements. Results: Current smoking and drinking status were the top two CVD risk factors in the study population. Dai ethnic minority participants had the highest prevalence of hypertension, obesity, and central obesity, whereas Jing Po ethnic minority participants had the highest prevalence of current smoking status, SHS exposure, and current drinking status (P < 0.01). Han participants had the highest prevalence of diabetes and physical inactivity (P < 0.01). 11.1% of all participants did not have any of the studied CVD risk factors, while 68.6% of Han, 60.2% of Na Xi, 50.7% of Li Shu, 82.2% of Dai, and 73.0% of Jing Po participants had clustering of two or more CVD risk factors. Prevalence of CVD risk factor clusters increased with age (P < 0.01). Males and individuals with lower education levels and lower annual household income were more likely to have CVD risk factors than their counterparts (P < 0.01). Conclusion: Clustering of CVD risk factors is common in rural southwest China. Ethnicity and individual SES significantly impact prevalence of CVD risk factors and their clustering.
MeSH term(s)	Adult ; Aged ; Alcohol Drinking/adverse effects ; Alcohol Drinking/ethnology ; Asian Continental Ancestry Group ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/ethnology ; China/epidemiology ; Cigarette Smoking/adverse effects ; Cigarette Smoking/ethnology ; Comorbidity ; Cross-Sectional Studies ; Educational Status ; Exercise ; Female ; Health Status Disparities ; Health Surveys ; Humans ; Hypertension/ethnology ; Income ; Life Style/ethnology ; Male ; Middle Aged ; Obesity, Abdominal/ethnology ; Prevalence ; Risk Assessment ; Risk Factors ; Sedentary Behavior/ethnology ; Social Determinants of Health/ethnology ; Tobacco Smoke Pollution/adverse effects
Chemical Substances	Tobacco Smoke Pollution
Language	English
Publishing date	2019-08-19
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-019-1185-1
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Article ; Online: Socioeconomic and lifestyle determinants of the prevalence of hypertension among elderly individuals in rural southwest China: a structural equation modelling approach.

Xiao, Li / Le, Cai / Wang, Gui-Yi / Fan, Lu-Ming / Cui, Wen-Long / Liu, Ying-Nan / Shen, Jing-Rong / Golden, Allison Rabkin

BMC cardiovascular disorders

2021 Volume 21, Issue 1, Page(s) 64

Abstract: Background: This study examines the association between socioeconomic and lifestyle factors and the prevalence of hypertension among elderly individuals in rural Southwest China.: Methods: A cross-sectional survey of 4833 consenting adults aged ≥ 60 ... ...

Abstract	Background: This study examines the association between socioeconomic and lifestyle factors and the prevalence of hypertension among elderly individuals in rural Southwest China. Methods: A cross-sectional survey of 4833 consenting adults aged ≥ 60 years in rural regions of Yunnan Province, China, was conducted in 2017. Data on individual socioeconomic status, sleep quality, physical activity level, and family history of hypertension were collected with a standardized questionnaire. Blood pressure, fasting blood glucose, height, weight, and waist circumference were also measured. An individual socioeconomic position (SEP) index was constructed using principal component analysis. Structural equation modelling (SEM) was applied to analyse the association between socioeconomic and lifestyle factors and the prevalence of hypertension. Results: The overall prevalence of hypertension was 50.6% in the study population. Body fat distribution, including measures of obesity and central obesity, had the greatest total effect on hypertension (0.21), followed by family history of hypertension (0.14), biological sex (0.08), sleep quality (- 0.07), SEP (- 0.06), physical inactivity (0.06), and diabetes (0.06). Body fat distribution, SEP, and family history of hypertension had both direct and indirect effects on hypertension, whereas physical inactivity, diabetes, and sleep quality were directly associated with the prevalence of hypertension. Biological sex was indirectly associated with the prevalence of hypertension. Conclusions: SEP, body fat distribution, physical inactivity, diabetes, and sleep quality critically influence the prevalence of hypertension. Future interventions to prevent and control hypertension should give increased attention to individuals with low SEP and should focus on controlling diabetes and obesity, increasing physical activity levels, and improving quality of sleep among older adults aged ≥ 60 years in rural Southwest China.
MeSH term(s)	Adiposity ; Age Factors ; Aged ; Blood Pressure ; China/epidemiology ; Cross-Sectional Studies ; Diabetes Mellitus/epidemiology ; Female ; Health Surveys ; Humans ; Hypertension/diagnosis ; Hypertension/epidemiology ; Hypertension/physiopathology ; Latent Class Analysis ; Life Style ; Male ; Middle Aged ; Obesity/epidemiology ; Prevalence ; Risk Assessment ; Risk Factors ; Rural Health ; Sedentary Behavior ; Sleep ; Social Determinants of Health ; Socioeconomic Factors
Language	English
Publishing date	2021-02-02
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-021-01885-y
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