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Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures

Vellakkal, Sukumar ; Subramanian, S V ; Millett, Christopher ; Basu, Sanjay ; Stuckler, David ; Ebrahim, Shah Wiley, Andrea S.

PloS one, 2013-07, Vol.8 (7), p.e68219-e68219 [Periódico revisado por pares]

United States: Public Library of Science

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Título:
Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures
Autor: Vellakkal, Sukumar ; Subramanian, S V ; Millett, Christopher ; Basu, Sanjay ; Stuckler, David ; Ebrahim, Shah
Wiley, Andrea S.
Assuntos: Adolescent ; Adult ; Affluence ; Age ; Analysis ; Angina ; Angina Pectoris - epidemiology ; Asthma ; Asthma - epidemiology ; Biology ; Cardiovascular disease ; Chronic Disease - epidemiology ; Chronic illnesses ; Communicable diseases ; Depression - epidemiology ; Discrimination in medical care ; Diseases ; Education ; Female ; Health care ; Humans ; Hypertension ; Hypertension - epidemiology ; India ; India - epidemiology ; Low income groups ; Lung diseases ; Male ; Mathematical analysis ; Medical care discrimination ; Medical diagnosis ; Medicine ; Mental depression ; Middle Aged ; Poverty ; Prevalence ; Social and Behavioral Sciences ; Socioeconomic Factors ; Socioeconomics ; Surveys ; Vision Disorders - epidemiology
É parte de: PloS one, 2013-07, Vol.8 (7), p.e68219-e68219
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Conceived and designed the experiments: SV SVS SE. Performed the experiments: SV SVS CM SB DS SE. Analyzed the data: SV. Contributed reagents/materials/analysis tools: SV SVS CM SB DS SE. Wrote the paper: SV SVS CM SB DS SE. Conceptualized the study: SV SE. Did the data analysis, interpretation of results and first draft of the paper: SV. Contributed during the conceptualization and interpretation of results and substantially contributed to the revision: CM SB DS SVS SE. Reviewed the final draft of the paper: SVS CM SB DS SE SV. Supervised the study: SE SVS.
Competing Interests: The authors have declared that no competing interests exist.
Descrição: Whether non-communicable diseases (NCDs) are diseases of poverty or affluence in low-and-middle income countries has been vigorously debated. Most analyses of NCDs have used self-reported data, which is biased by differential access to healthcare services between groups of different socioeconomic status (SES). We sought to compare self-reported diagnoses versus standardised measures of NCD prevalence across SES groups in India. We calculated age-adjusted prevalence rates of common NCDs from the Study on Global Ageing and Adult Health, a nationally representative cross-sectional survey. We compared self-reported diagnoses to standardized measures of disease for five NCDs. We calculated wealth-related and education-related disparities in NCD prevalence by calculating concentration index (C), which ranges from -1 to +1 (concentration of disease among lower and higher SES groups, respectively). NCD prevalence was higher (range 5.2 to 19.1%) for standardised measures than self-reported diagnoses (range 3.1 to 9.4%). Several NCDs were particularly concentrated among higher SES groups according to self-reported diagnoses (Csrd) but were concentrated either among lower SES groups or showed no strong socioeconomic gradient using standardized measures (Csm): age-standardised wealth-related C: angina Csrd 0.02 vs. Csm -0.17; asthma and lung diseases Csrd -0.05 vs. Csm -0.04 (age-standardised education-related Csrd 0.04 vs. Csm -0.05); vision problems Csrd 0.07 vs. Csm -0.05; depression Csrd 0.07 vs. Csm -0.13. Indicating similar trends of standardized measures detecting more cases among low SES, concentration of hypertension declined among higher SES (Csrd 0.19 vs. Csm 0.03). The socio-economic patterning of NCD prevalence differs markedly when assessed by standardized criteria versus self-reported diagnoses. NCDs in India are not necessarily diseases of affluence but also of poverty, indicating likely under-diagnosis and under-reporting of diseases among the poor. Standardized measures should be used, wherever feasible, to estimate the true prevalence of NCDs.
Editor: United States: Public Library of Science
Idioma: Inglês

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Socioeconomic inequalities in non-communicable diseases prevalence in India: disparities between self-reported diagnoses and standardized measures

Vellakkal, Sukumar ; Subramanian, S V ; Millett, Christopher ; Basu, Sanjay ; Stuckler, David ; Ebrahim, Shah Wiley, Andrea S.

United States: Public Library of Science

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