Key result
Men living in rural areas had a lower prevalence of hypertension compared to those in urban areas (OR 0.80), while lower socioeconomic status was associated with worse disease control particularly among urban residents.
Why the study?
Does residential area (urban vs rural) affect the prevalence, awareness, treatment, and control of hypertension and diabetes in South Korean adults?
Cross-Sectional (n=17,292)
Does residential area (urban vs rural) affect the prevalence, awareness, treatment, and control of hypertension and diabetes in South Korean adults?
Odds Ratio: 0.8 (95% CI 0.67–0.96)
Inequality in the control of hypertension and diabetes is more pronounced among the urban poor compared to rural residents in South Korea, highlighting the need for targeted urban health policies.
Urban SES disparities in hypertension control may warrant targeted policies; hypothesis-generating and requires prospective confirmation before practice change.
BACKGROUND: This 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. METHODS: This 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. RESULTS: The 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). CONCLUSIONS: After 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.
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Jeon et al. (2016) conducted a cross-sectional in Hypertension and Diabetes (n=17,292). Rural residential area vs. Urban residential area was evaluated on Prevalence of hypertension in men (OR 0.80, 95% CI 0.67-0.96). Men living in rural areas had a lower prevalence of hypertension compared to those in urban areas (OR 0.80), while lower socioeconomic status was associated with worse disease control particularly among urban residents.
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