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Liu M, Yang Y, Lyu X, Zhang J, Liu Y, Xu D, Wu H, Lei J, Deng Y, Zhao C, Hu X, Xie W, Huang J, Wu S, Zhang Y, Zhang H, He Y, Peng Z, Wang Y, Shen H, Wang Q, Zhang Y, Yan D, Wang L, Ma X. Declined prevalence, improved awareness and control of hypertension are associated with spousal educational attainment: A mega-data study. Soc Sci Med 2023; 336:116256. [PMID: 37778143 DOI: 10.1016/j.socscimed.2023.116256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/30/2023] [Accepted: 09/17/2023] [Indexed: 10/03/2023]
Abstract
Cardiovascular diseases, including hypertension, have posed a serious threat to human health in recent decades. Family-centered health promotion and disease control for the management of hypertension is gaining attention. In this study, we assessed the association between spousal educational attainment (SEA) and hypertension prevalence, awareness, and control, intending to provide new directions for family health care. A total of 71 211 191 reproductive-aged participants from the National Free NFPCP during 2013-2019 were included in the current study. Inverse probability weighting (IPW) via propensity models were used to adjust for the imbalance by SEA. Both multivariable-adjusted ORs and inverse-probability-weighted ORs were used to assess the association between SEA and the prevalence, awareness, and control of hypertension. ORs of prevalence, awareness, and control of hypertension with SEA stratified by sex, age, and residency type were also reported. Compared with participants with SEA of compulsory education, the inverse-probability-weighted ORs for hypertension were 0.97 (0.96-0.97), 0.99 (0.98-1.00), and 0.91 (0.88-0.93) for participants with SEA of senior high, college, and postgraduate, respectively. The corresponding ORs for hypertension awareness were 1.12 (1.10-1.13), 1.15 (1.13-1.16), and 1.38 (1.34-1.41). The increment of hypertension control associated with SEA was only identified in urban areas. Modification analyses revealed that urban participants were observed to have more healthy benefits associated with SEA; additional decreased prevalent hypertension and increased hypertension awareness associated with SEA were observed in wives and husbands respectively. Thus, SEA was associated with decreased prevalent hypertension and increased awareness and control of hypertension. Our findings call for increased participation of spouses in family-centered healthcare, with consideration of modified effects by gender, age, and residency type, to improve chronic disease prevention and control including hypertension.
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Affiliation(s)
- Meiya Liu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ying Yang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China.
| | - Xinyi Lyu
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China
| | - Jieying Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Youhong Liu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Die Xu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Hanbin Wu
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Jueming Lei
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Yuzhi Deng
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Chuanyu Zhao
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China
| | - Xuan Hu
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Wenlu Xie
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Jiaxin Huang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Siyu Wu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Ya Zhang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Hongguang Zhang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Yuan He
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China
| | - Zuoqi Peng
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China
| | - Yuanyuan Wang
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China
| | - Haiping Shen
- Department of Maternal and Child Health, National Health Commission of the PRC, Beijing, China
| | - Qiaomei Wang
- Department of Maternal and Child Health, National Health Commission of the PRC, Beijing, China
| | - Yiping Zhang
- Department of Maternal and Child Health, National Health Commission of the PRC, Beijing, China
| | - Donghai Yan
- Department of Maternal and Child Health, National Health Commission of the PRC, Beijing, China
| | - Long Wang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, China.
| | - Xu Ma
- National Research Institute for Family Planning, Beijing, China; National Human Genetic Resources Centre, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China.
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Quiroga-Padilla PJ, Gaete PV, Nieves-Barreto LD, Montaño A, Betancourt EC, Mendivil CO. Social inequalities shape diet composition among urban Colombians: The Colombian Nutritional Profiles cross-sectional study. Public Health Nutr 2021; 25:1-30. [PMID: 34889172 PMCID: PMC9991857 DOI: 10.1017/s1368980021004778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 10/18/2021] [Accepted: 11/30/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To explore the influence of socioeconomic position on habitual dietary intake in Colombian cities. DESIGN We conducted a cross-sectional, population-based study in five Colombian cities. Dietary intake was assessed with a 157-item semi-quantitative food frequency questionnaire previously developed for the Colombian population. Nutrient analysis was performed using national and international food composition tables. Socioeconomic position was assessed with two indicators: a government-defined, asset-based, household-level index called socioeconomic stratum (SES) and, among adults, highest educational level attained. SETTING The five main urban centers of Colombia: Bogotá, Medellin, Barranquilla, Cali and Bucaramanga. PARTICIPANTS Probabilistic, multistage sample of 1865 participants (n=1491 for analyses on education). RESULTS For both sexes, increasing SES was associated with a lower consumption of energy (p-trend <0.001 in both sexes), carbohydrates (p-trend ˂0.001 in both sexes), sodium (p-trend=0.005 in males, <0.001 in females), saturated fatty acids (p-trend <0.001 in both sexes) and among females, cholesterol (p-trend=0.002). More educated men consumed significantly less energy and carbohydrates (p-trend=0.036 and ˂0.001, respectively). Among men, intake of trans fats increased monotonically with educational level, being 21% higher among college graduates relative to those with only elementary education (p-trend=0.023). Among women, higher educational level was associated with higher MUFA intake (p-trend=0.027). CONCLUSIONS SES and educational level are strong correlates of the usual diet of urban Colombians. Economically deprived and less educated segments of society display dietary habits that make them vulnerable to chronic diseases and should be the primary target of public health nutrition policies.
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Affiliation(s)
- Pedro J Quiroga-Padilla
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá110111, Colombia
| | - Paula V Gaete
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá110111, Colombia
| | - Luz D Nieves-Barreto
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá110111, Colombia
| | - Angélica Montaño
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá110111, Colombia
| | - Eddy C Betancourt
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá110111, Colombia
- Team Foods Colombia, Bogotá, Colombia
| | - Carlos O Mendivil
- Universidad de los Andes, School of Medicine, Carrera 7 No 116-05, Of 413, Bogotá110111, Colombia
- Fundación Santa Fe de Bogotá, Section of Endocrinology, Bogotá, Colombia
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