Table 3.
Socioeconomic factors and diabetes
| a)Inequality index and diabetes | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No | Reference | Study design and Setting | Study year | Participants and their recruitment | Sex | Age (Year) | Inequality Assessment Method | Concentration Index measure(±SE) related to Diabetes | Main Conclusion | Suggestion | |
| 1 | Emamian MH, et al. 2011[ 27 ] | Cross sectional study, Population based/ Shahroud | 2005 | General Population, Random sampling/ n=1000(5.3% diabetic patients) | Both/Female (50%) | 15-64 | Concentration Index | Both | 0.044±0.072 | Concentration curve difference from the line of equality for diabetes isn’t significant. | Especial attention to poverty alleviation in upper age groups according to the role of age and low economic status in NCDs' occurrence |
| Female | 0.074±0.09 | Age, governmental employee, being unmarried, residence in rural area and low economic status are the most important factors which influence on NCDs' inequalities. | |||||||||
| Male | 0.001 ± 0.115 | ||||||||||
| b)Diabetes prevalence | |||||||||||
| No | Reference | Study design and Setting | Study year | Participants and their recruitment | Sex | Age (Year) | Socioeconomic Factors | OR (95% CI) | Main Conclusion | Suggestion | |
| 2 | Maddah, M. 2010[ 28 ] | Cross sectional study, Population based/ Gilan | 2007 | General Population, random sample/n=9046(10.8% diabetic patients) | Female | ≥25 years | Age/Educational levels/living areas | Diabetes and SEF | Increasing age in women associated with diabetes and in women living in low income areas, diabetes is more prevalent. In addition, diabetes is more common in the lowest educational level. | Prevention of diabetes in Iranian women especially in low socioeconomic level | |
| Age | 0.9 (0.8–0.9) | ||||||||||
| Educational levels (years)<5 | 1.36(0.51-3.65) | ||||||||||
| Living in low income area | 1.43 (1.05-1.94) | ||||||||||
| 3 | Golozar A. et al. 2011[ 29 ] | Cross sectional study, Population based/ Golestan | 2007 | Diabetic Patients/Systematic clustering/n=3453 | Both/Female (68.08%) | 30 -87 | Gender | Diabetes and SEF | The diabetes prevalence increased 21% for every 10-year increase in age. In urban area, non-Turkmen ethnicity, low economic status and illiterate persons, diabetes is more prevalent. Socioeconomic status was inversely associated with diabetes prevalence. | Improving DM awareness, improving general living conditions, and early lifestyle modifications | |
| Educational level/ | Female | 1.62(1.5-1.74) | |||||||||
| Economic status/ | Illiterate | 1.26(1.16-1.36) | |||||||||
| Residence | Low economic status | 1.52(1.41-1.64) | |||||||||
| Urban | 1.56 (1.45-1.69) | ||||||||||
| 4 | Azimi-Nezhad, M.et al. 2008[ 31 ] | Cross sectional study, Populatio5n based/ Khorasan | 2008 | General Population, cluster-stratified sampling/n=3778 (5.5% diabetic patients) | Both/Female (50 %) | 15-64 | Gender/Age/Educational level/Occupation/Marital status/Residence | Diabetes and SEF | Diabetes is prevalent in urban areas, female persons, and retirees and unemployed. There was no association between education, marital status and diabetes. | Primary prevention by lifestyle interventions especially in urban area. The preventive strategies should be based on the affective factors | |
| Female | 1.15(0.86-1.52) | ||||||||||
| Age,≥ 50 | 3.13(2.34-4.17) | ||||||||||
| Married | 0.91(0.59-1.39) | ||||||||||
| Illiterate | 1.19 (0.88-1.6) | ||||||||||
| Retired | 2.41(1.52-3.82) | ||||||||||
| Unemployed | 2.05(1.13-3.72) | ||||||||||
| Urban | 2.73(1.89–3.92) | ||||||||||
| 5 | Veghari, Gh. et al. 2010[ 30 ] | Cross sectional study, Population based/ Golestan | General Population, stratified sampling/n=1998(8.3 diabetic patients) | Both/Female (49.9%) | 25- 65 | Gender | Hyperglycemia and SEF | The diabetes is more prevalent in women than men. Age > 55years, illiteracy, and residence in urban area have OR>1 with Hyperglycemia. | Screening and education of DM patients. | ||
| Age | Female | 1.48(1.07-2.05) | |||||||||
| Educational level/ | Age ,≥ 55 | 3.31 (2.38-4.60) | |||||||||
| Economic status/ | Illiterate | 1.37 (0.99-1.90) | |||||||||
| Residence | Urban | 1.52 (1.10-2.10) | |||||||||
| Low and medium economic status | 1.16 (0.46-2.91) | ||||||||||
| 6 | Shahraki, M. et al. 2012[ 32 ] | Cross sectional study, Clinical Based/ Zahedan | 2012 | Overweight and obese women/Non random sampling n=811 | Female | 20–60 | Age/Educational level | FBS levels and SEF | Age and education significantly associated with FBS levels. | Encourage to physical activity and healthy diet among women | |
| ≤ Age50 | 3.8 (1.798.45) | ||||||||||
| Educational level≤12 | 1.9 (1.25 -3.15) | ||||||||||
| c) Diabetes control | |||||||||||
| NO | Reference | Study design and Setting | Study year | Participants and their recruitment | Sex | Age (Year) | Socioeconomic Factors | OR (95% CI) | Main Conclusion | Suggestion | |
| 7 | Farajzadegan, Z. et al. 2013[ 33 ] | Cross sectional study, Population based/ Isfahan | 2010 | Diabetic patients, random sampling/n=120 | Both/Female (81.6%) | ≥30 years | Gender | Diabetes control and SEF | There was a significant negative correlation between total social capital score and diabetes control. Also empowerment and political action and trust and solidarity dimensions and the level of HbA1c have negative correlation. | The creation of social capital to improve diabetes control | |
| Occupation | Female | 1.56(0.61-4.00) | |||||||||
| Housewife | 2.22(0.95-5.19) | ||||||||||
| Retired | 3.22(0.62-16.65) | ||||||||||
| 8 | Mirzazadeh, A. et al. 2009[ 36 ] | National Cross sectional study, population-based / Iran | 2005 | General population, random sampling/n=89 (5.6% diabetic patients) | Both/Female | 25–64 | Age | Diabetes control and SEF | Inhabitants in rural areas controlled diabetes better than who lived in an urban area. Also, control of the fasting plasma glucose level was better in younger diabetic patients. | More attention to elderly diabetic patients(Particularly those in urban areas) | |
| Gender | Female | 1.13(0.97-1.32) | |||||||||
| Marital status | Age>55 | 5.29(3.42-8.18) | |||||||||
| Educational level | Married | 1 | |||||||||
| Residence | Single | 0.94(0.59-1.54) | |||||||||
| Illiterate | 1 | ||||||||||
| literate | 1.11(0.93-1.32) | ||||||||||
| Urban | 1.39(1.16-1.67) | ||||||||||
| 9 | Esmaeil-Nasab, N. et al. 2010[ 35 ] | Cross sectional study, Clinical Based/Sanandaj | 2008 | Type 2 Diabetic patients/random sampling/n-411 | Both/Female (74.5%) | >25 | Gender | HgA1c<6 and SEF | There was significant correlation between HgA1c and sex, age, educational level and occupation. OR between age and HgA1c was 1.2. | ---- | |
| Educational level | Male | 2.46(1.37-4.42) | |||||||||
| Occupation | Illiterate | 3.42(2.16-5.40) | |||||||||
| Unemployed | 2.59 (1.27-5.26) | ||||||||||
| 10 | Jahanlou, A. S. et al. 200[ 37 ] | Cross sectional study, Clinical Based/ Bandarabas | 2007 | Diabetic patients/Non random sampling 4=140 | Both/Female (67.5%) | 27-72 | Educational level | HbA1c level and Educational level | Illiteracy and HbA1c >7 have OR (1.24) but Literacy level does not have a role in glycemic control. | Promotion health literacy | |
| Illiterate | 1.24 (0.72-2.14) | ||||||||||
| >7 years schooling | 1.12(0.64-1.94) | ||||||||||
| d) Diabetes complications | |||||||||||
| NO | Reference | Study design and Setting | Study year | Participants and their recruitment | Sex | Age (Year) | Socioeconomic Factors | Association | Main Conclusion | Suggestion | |
| 11 | Tol, A. et al. 2013[ 38 ] | Cross sectional study, Clinical Based/ Isfahan | 2009 | Diabetics Patients, Random sampling /n=384 | Both/Female (47.9%) | 25-99 | Age/ Educational level/Incom | Relation between number of complications in diabetics patients and SEF | Three complications in the age group of 60 to 70 years old were more prevalent. Three complications in higher education levels were seen. The highest numbers of complications were among housewives and retired people. Most diabetic patients with complications were in the income group of less than 7200 $ per year. | Applying the supportive resources and strategies | |
| Age/ | Sig (P<0.001) | ||||||||||
| Educational level/ | Sig (P<0.001) | ||||||||||
| Income | Sig (P<0.001) | ||||||||||
| 12 | Tol, A. et al. 2012[ 39 ] | Cross sectional study, Hospital Based/ Tehran | 2010 | Type 2 diabetic patients with complications/Non random sampling/n=450 | Both / Female (46%) | ≥25 years | Gender | Relation between number of complications in diabetics patients and SEF | Complications' frequency demonstrated significant relation with sex (female), age, educational level, type of occupation, and social class. The majority of patients (54.2%) belonged to low income group. | Empowering diabetic patients | |
| Age | Female | Sig (P<0.001) | |||||||||
| Educational level/ | Age | Sig (P<0.001) | |||||||||
| Occupation/ | Educational level | Sig (P<0.001) | |||||||||
| Marital Status | |||||||||||
| Family Annual | Occupation | Sig (P<0.001) | |||||||||
| Income | Marital status | Non Sig | |||||||||
| Family Annual Income | Sig (P<0.001) | ||||||||||
| 13 | Rahimian Boogar, I. et al. 2011[ 40 ] | Cross sectional study, Clinical Based/ Tehran | 2010 | Type 2 diabetic patients, convenience sampling/n=246 | Both/Female (55.6%) | 28-57 | Gender | CVD Probability in diabetes patients and SEF (Odds ratio) | Sex and age of onset of diabetes are associated with cardiovascular complications among diabetic patients. | Planning preventive intervention for diabetes | |
| Age | Male | 1.79(0.99-3.22) | |||||||||
| Quality of life | Age of onset of diabetes(<45) | 1.13(0.63-2.03) | |||||||||
| Self management | |||||||||||
| e) Other related subjects to diabetes | |||||||||||
| No | Reference | Study design and Setting | Study year | Participants and their recruitment | Sex | Age (Year) | Socioeconomic Factors | OR (95% CI) | Main Conclusion | Suggestion | |
| 14 | Shirani, S.et al. 2009[ 41 ] | Cross sectional study, Population based/ Isfahan, Najafabad, Arak | 2001 | General Population, Random sampling/ n=12514 (5.6% diabetic patients) | Both/Female (51%) | ≥19 years | Gender | Awareness of Diabetes AND SEF | Female sex, age > 30 years, educational levels under diploma, retired situation, and married status have OR>1 with awareness of diabetes. | Community-based intervention programme/Public health measuring | |
| Age | Female | 2.15 (0.53-7.74) | Public health measuring | ||||||||
| Educational level/ | Age, ≥ 60 | 6.23 (2.14–18.11) | |||||||||
| Occupation/ | Illiterate | 1.4 (0.56–3.5) | |||||||||
| Marital status/ | Unemployed | 0.92 (0.37-2. 30) | |||||||||
| Residence | Retired | 1.06(0.46–2.44) | |||||||||
| Married | 1.26 (0.77–2.06) | ||||||||||
| Urban | 0.96 (0.66–1.40) | ||||||||||
| 15 | Najibi N, et al. 2013[ 42 ] | Cross sectional study, Clinical Based/ Fars | 2011 | Type 2 Diabetic patients/Random sampling/n=135 | Both/Female (73.3%) | 30-55 | Economic status/Income/Family size/Number of childres | Food insecurity and SEF | Food insecurity was significantly associated with economic status, education level, income, having child under 18 years of age, family size, and number of children ,but there was not a significant relationship between food Insecurity and occupation, marital status. | Economic status promotion | |
| Economic | 0.22(−0/57-0/08) status | ||||||||||
| Income | 0.19(0/07-0/54) | ||||||||||
| Family size | 3.9(1/53-9/94) | ||||||||||
| Number of children | 3.5(1.23-9.97) | ||||||||||