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Saudi J Kidney Dis Transpl. 2019 Sep-Oct;30(5):1084-1096. doi: 10.4103/1319-2442.270264.

A narrative review of the impacts of income, education, and ethnicity on arterial hypertension, diabetes mellitus, and chronic kidney disease in the world.

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Department of Health, Institute for Studies and Research in Nephrology from Minas Gerais (IMEPEN Foundation), Juiz de Fora, Minas Gerais, Brazil.
Department of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.


Nontransmissible chronic diseases (NTCDs) are the leading causes of death worldwide, causing serious social and economic consequences in all societies and economies and emerging as a major public health problem. One of the ways of coping the social and economic impact caused by the NTCDs is the elaboration of effective public policies; one of the instruments used for the elaboration of public policies is the social indicators. The most popular indicator at present is the Human Development Index (HDI), which covers the dimensions of longevity, education, and income. The Inequality-adjusted HDI (IHDI) was implemented that quantifies the effects of inequality in development, measured in terms of HDI. The objective of the present study was to analyze the impact of income, education, and ethnicity in hypertension, diabetes mellitus (DM), and chronic kidney disease (CKD) in the world, through the narrative review of the literature and analyzing the social indicators HDI and IHDI of the countries analyzed. After analyzing 161 studies from 96 countries, we identified that income, education, and color impact on the prevalence, incidence, diagnosis, treatment, progression, and mortality of hypertension, DM, and CKD in both low- and middle-income countries' development, as well as high and very high human development. The HDI data for all countries change when adjusted for inequality. The theme related to social factors needs to be a constant in the elaboration of health policies, as well as present in the professional doing.

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