|Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: findings from a nationwide cross-sectional survey|
||Tuhin Biswas, Nick Townsend, Saimul Islam, Rajibul Islam, Rajat Das Gupta, Sumon Kumar Das, and Abdullah Al Mamun
||BMJ Open, 9: e025538; DOI: 10.1136/bmjopen-2018-025538
||Objectives This study aimed to examine the prevalence and distribution in the comorbidity of non-communicable diseases (NCDs) among the adult population in Bangladesh by measures of socioeconomic status (SES).
Design This was a cross-sectional study.
Setting This study used Bangladesh Demographic and Health Survey 2011 data.
Participants Total 8763 individuals aged =35 years were included.
Primary and secondary outcome measures The primary outcome measures were diabetes mellitus (DM), hypertension (HTN) and overweight/obesity. The study further assesses factors (in particular SES) associated with these comorbidities (DM, HTN and overweight/obesity).
Results Of 8763 adults, 12% had DM, 27% HTN and 22% were overweight/obese (body mass index =23?kg/m2). Just over 1% of the sample had all three conditions, 3% had both DM and HTN, 3%?DM and overweight/obesity and 7% HTN and overweight/obesity. DM, HTN and overweight/obesity were more prevalent those who had higher education, were non-manual workers, were in the richer to richest SES and lived in urban settings. Individuals in higher SES groups were also more likely to suffer from comorbidities. In the multivariable analysis, it was found that individual belonging to the richest wealth quintile had the highest odds of having HTN (adjusted OR (AOR) 1.49, 95% CI 1.29 to 1.72), DM (AOR 1.63, 95%?CI 1.25 to 2.14) and overweight/obesity (AOR 4.3, 95%?CI 3.32 to 5.57).
Conclusions In contrast to more affluent countries, individuals with NCDs risk factors and comorbidities are more common in higher SES individuals. Public health approaches must consider this social patterning in tackling NCDs in the country.