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Logo of bmcphBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Public Health
 
BMC Public Health. 2012; 12: 474.
Published online 2012 June 22. doi:  10.1186/1471-2458-12-474
PMCID: PMC3490890
Copyright ©2012 Hosseinpoor et al.; licensee BioMed Central Ltd.
Socioeconomic inequality in the prevalence of noncommunicable diseases in low- and middle-income countries: Results from the World Health Survey
Ahmad Reza Hosseinpoor,corresponding author1 Nicole Bergen,1 Shanthi Mendis,2 Sam Harper,3 Emese Verdes,1 Anton Kunst,4 and Somnath Chatterji1
1Department of Health Statistics and Information Systems, World Health Organization, Geneva, Switzerland
2Department of Chronic Diseases and Health Promotion, World Health Organization, Geneva, Switzerland
3Department of Epidemiology, Biostatistics & Occupational Health, McGill University, Montreal, Canada
4Department of Public Health, AMC, University of Amsterdam, Amsterdam, Netherlands
corresponding authorCorresponding author.
Ahmad Reza Hosseinpoor: hosseinpoora/at/who.int; Nicole Bergen: nicolejbergen/at/gmail.com; Shanthi Mendis: mendiss/at/who.int; Sam Harper: sam.harper/at/mcgill.ca; Emese Verdes: verdese/at/gmail.com; Anton Kunst: A.Kunst/at/amc.uva.nl; Somnath Chatterji: chatterjis/at/who.int
Received December 12, 2011; Accepted May 30, 2012.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background
Noncommunicable diseases are an increasing health concern worldwide, but particularly in low- and middle-income countries. This study quantified and compared education- and wealth-based inequalities in the prevalence of five noncommunicable diseases (angina, arthritis, asthma, depression and diabetes) and comorbidity in low- and middle-income country groups.
Methods
Using 2002–04 World Health Survey data from 41 low- and middle-income countries, the prevalence estimates of angina, arthritis, asthma, depression, diabetes and comorbidity in adults aged 18 years or above are presented for wealth quintiles and five education levels, by sex and country income group. Symptom-based classification was used to determine angina, arthritis, asthma and depression rates, and diabetes diagnoses were self-reported. Socioeconomic inequalities according to wealth and education were measured absolutely, using the slope index of inequality, and relatively, using the relative index of inequality.
Results
Wealth and education inequalities were more pronounced in the low-income country group than the middle-income country group. Both wealth and education were inversely associated with angina, arthritis, asthma, depression and comorbidity prevalence, with strongest inequalities reported for angina, asthma and comorbidity. Diabetes prevalence was positively associated with wealth and, to a lesser extent, education. Adjustments for confounding variables tended to decrease the magnitude of the inequality.
Conclusions
Noncommunicable diseases are not necessarily diseases of the wealthy, and showed unequal distribution across socioeconomic groups in low- and middle-income country groups. Disaggregated research is warranted to assess the impact of individual noncommunicable diseases according to socioeconomic indicators.
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