Abstract
BackgroundObesity and metabolic diseases represent a major health burden in the Caribbean, particularly since a large part of the population is disadvantaged. However, socioeconomic inequalities in chronic diseases are poorly explored in this region. We investigated the association between socioeconomic position and metabolic syndrome (MetS) prevalence and explored the contribution of diet quality to explain this association, among adults in the French West Indies.MethodsThis cross-sectional analysis included 1144 subjects (≥16 y) from a multistage sampling survey conducted in 2013–2014 on a representative sample of the Guadeloupean and Martinican population. MetS prevalence was assessed using the Joint Interim Statement. Dietary intakes were estimated from 24 h-dietary recalls, and diet quality was assessed through the Diet Quality Index-International (DQI-I). Associations between socioeconomic indicators (education, employment, social assistance benefits) and MetS prevalence, and the potential contribution of diet quality in this association were assessed using multivariable logistic regression models, adjusted for sociodemographic characteristics.ResultsMetS prevalence adjusted for age and sex was 21 and 30% among Guadeloupean and Martinican, respectively. Compared to high-educated participants, low-educated subjects were more likely to be at risk of MetS (OR = 2.4; 95%CI = [1.3–4.4], respectively), as were recipients of social assistance benefits compared to non-recipients (OR = 2.0; 95%CI = [1.0–4.0]). The DQI-I explained 10.5% of the overall variation in MetS due to education.ConclusionsSocioeconomic inequalities in MetS prevalence, reflected by education and social assistance benefits, were found. However, diet quality contributed only to socioeconomic inequalities due to education underlining that education may impact health through the ability to generate overall dietary behavior, long-term beneficial. Our work identified subgroups with higher risk of MetS, which is needed when implementing public health measures, particularly in this Caribbean population with of high poverty rates. Further prospective studies are needed to improve our understanding of the mechanisms of social inequalities in MetS in a high poverty rates context.
Highlights
Obesity and metabolic diseases represent a major health burden in the Caribbean, since a large part of the population is disadvantaged
No difference according to location was observed except for metabolic syndrome (MetS) prevalence, which was markedly higher in Martinique than in Guadeloupe, the percentage of single-parent households, which was twice as high in Guadeloupe as in Martinique, and the mean Diet Quality Index-International (DQI-I), which was higher in Guadeloupe (Table 1)
Our study showed that risks of MetS according to social assistance benefits and education in models adjusted for the two other socioeconomic position indicators remained significant, even they were slightly lower than in models not adjusted for other socioeconomic markers
Summary
Obesity and metabolic diseases represent a major health burden in the Caribbean, since a large part of the population is disadvantaged. Positive associations between prevalence of MetS and higher education and income were found in Jamaican men but not in women [8] This finding may reflect the early stage of Jamaica’s epidemiological transition in the 90s and the situation may have changed since . None of these studies examined simultaneously the three most frequently used socioeconomic indicators: education, employment status and income. They are generally weakly correlated suggesting some shared association and that they are conceptually distinct, and their influence is transmitted by different social processes [21,22,23]. The identification of subgroups in Caribbean populations who are at higher risk of MetS is a key element when implementing public health measures, in the current Caribbean context of widespread poverty and social inequalities in chronic diseases [24]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
