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J Epidemiol Community Health. 2017 Jul;71(7):633-639. doi: 10.1136/jech-2016-208322. Epub 2017 Mar 27.

Association between socioeconomic position and the prevalence of type 2 diabetes in Ghanaians in different geographic locations: the RODAM study.

Author information

1
Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
2
Department of Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
3
Regional Institute for Population Studies, University of Ghana, Legon, Accra, Ghana.
4
Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
5
Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
6
Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
7
International Diabetes Federation, Kampala, Uganda.
8
Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Berlin, Germany.
9
Kumasi Centre for Collaborative Research in Tropical Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Abstract

BACKGROUND:

The prevalence of diabetes has been shown to be socially patterned but the direction of the association in low-income countries and among migrant populations in Europe has varied in the literature. This study examined the association between socioeconomic position (SEP) and diabetes in Ghanaians in Europe and in Ghana.

METHODS:

Data were derived from the multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study of Ghanaian adults aged 25-70 years residing in Europe (Amsterdam, Berlin and London) and in urban and rural Ghana. Educational attainment (elementary, secondary or higher) and occupational class (low or high) were used as indicators of SEP. Age-standardised prevalence of diabetes and prevalence ratios were evaluated separately for men and women of different SEP in Ghana and Europe.

RESULTS:

A total of 5290 participants were included in the analyses. The prevalence of diabetes decreased with increasing level of education in Ghanaian men and women in Europe and in men in urban Ghana, whereas diabetes prevalence increased with increasing level of education in men and women in rural Ghana. The association between occupational class and the prevalence of diabetes followed a less consistent pattern in men and women in the different locations.

CONCLUSIONS:

The association of diabetes and SEP differed in rural Ghana compared with urban settings in Ghana and Europe and comparing men and women, highlighting the complex interaction of SEP and the development of diabetes. These findings have important implications for diabetes prevention strategies in Ghanaians in different locations.

KEYWORDS:

Epidemiology of diabetes; INEQUALITIES; MIGRATION; SOCIO-ECONOMIC

PMID:
28348205
PMCID:
PMC5485755
DOI:
10.1136/jech-2016-208322
[Indexed for MEDLINE]
Free PMC Article

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