Abstract
BackgroundThis study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. In addition, the rate of good hypertension or diabetes control was examined separately in men and women, and in urban and rural areas.MethodsThis study used Korea National Health and Nutrition Examination V (2010–2012) data, a nationwide cross-sectional survey of general South Korean population. Residential areas were categorized into urban and rural areas.To examine differences between the residential areas in terms of prevalence, awareness, treatment, and control of hypertension and diabetes we performed a multivariate logistic regression adjusting for age, body mass index, physical activity, alcohol use, smoking, marital status, monthly income, and educational level. To investigate control of hypertension or diabetes within each residential area, we performed a subgroup analysis in both urban and rural areas.ResultsThe prevalence of hypertension is higher among men in urban areas than among those in rural areas (OR = 0.80; 95 % CI = 0.67–0.96, reference group = urban areas). However, the subgroups did not differ in terms of diabetes prevalence, awareness, treatment, and control. Regardless of both sex and residential area, participants in good control of their hypertension and diabetes were younger. Inequality in good control of hypertension was observed in men who lived in urban (≤Elementary school, OR 0.74, 95 % CI 0.60–0.92) and rural areas (≤Elementary school, OR 0.67, 95 % CI 0.46–0.99). Inequality in health status was found in women who resided in urban areas (≤Elementary school, OR 0.53, 95 % CI 0.37–0.75). Good control of diabetes also showed inequalities in health status for both men (≤Elementary school, OR 0.61, 95 % CI 0.40–0.94; Middle/High school, OR 0.69, 95 % CI 0.49–0.96) and women in urban areas (≤1 million won, OR 0.56, 95 % CI 0.33–0.93) (Reference group = ‘≥College’ for education and ‘>3 million’ Korean won for income).ConclusionsAfter correction for individual socioeconomic status, differences by residential area were not observed. However, when the participants with good disease control were divided by region, inequality was confirmed in urban residents. Therefore, differentiated health policies to resolve individual and regional health inequalities are necessary.
Highlights
This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas
Men living in rural areas had lower Body mass index (BMI) with fewer unhealthy alcohol users than those who lived in urban areas
Women living in rural areas had higher BMI with fewer unhealthy alcohol users than those who lived in urban areas
Summary
This study investigated whether the prevalence, awareness, treatment, and control of hypertension and diabetes differed by residential areas. The rate of good hypertension or diabetes control was examined separately in men and women, and in urban and rural areas. In Health Inequalities in South Korea, 2009 published by the Korean Society for Equity in Health, people of higher educational levels had consistently lower mortality rates for both men and women in 1995, 2000, and 2005 [3]. People with low levels of socioeconomic status had more prevalent hypertension and received less treatment [6, 7]. Diabetes was prevalent in people with low socioeconomic status in addition to hypertension [11, 12]. Diabetic patients with low socioeconomic status were hospitalized and visited emergency rooms more frequently [13]
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