Evaluation of social-economic inequality in the high CVD risk population with or without diabetes in China

Abstract

Background Epidemiological data showed that the comorbidities of cardiovascular disease and diabetes in China are very serious, but the comprehensive management of such patients is seriously inadequate and lack of standardization. Our study aimed to estimate the inequalities of those high CVD risk patients with or without diabetes in China, and analyze the contributors of inequalities problems. Method Data were derived from China Health and Retirement Longitudinal Study (CHARLS) conducted in 2011. The criteria of American Systolic Blood Pressure Intervention Trial (SPRINT) were used to estimate the prevalence of high CVD risk patients with or without diabetes in China. Concentration index was calculated to describe the economic-related inequality degree in high CVD risk patients with or without diabetes. A decomposition method was employed to analyze the cause of inequalities problems. Results The prevalence of high CVD risk patients with or without diabetes in China were 3.46% and 22.03% respectively. The concentration index of high CVD risk patients with or without diabetes in China were 0.0639 [ 95% CI: (0.0630, 0.0648)] and − 0.0628 [95% CI: (-0.0629, -0.0627)] respectively, indicating a pro-rich inequality in high CVD risk patients with diabetes and a pro-poor inequality in high CVD risk patients without diabetes. Location(rural or urban), age and BMI were the key factors to influence the pro-rich inequality in high CVD risk patients with diabetes. Age, socioeconomic status and education were the key factors to influence the pro-poor inequality in high CVD risk patients without diabetes. Conclusion Our study determined pro-rich inequality in high CVD risk patients with diabetes, but pro-poor in high CVD-risk without diabetes patients in China. SES and BMI mainly associated with the social-economic inequality in high CVD risk patients with or without diabetes.