伊朗糖尿病护理中的社会经济不平等级联：STEPS 2016和2021
Socioeconomic inequalities in diabetes care cascade in Iran: STEPS 2016 and 2021.
摘要(中文译文)
在伊朗，糖尿病负担不断上升以及近期卫生系统改革，凸显了评估糖尿病照护连续过程中不平等现象的必要性。我们评估了伊朗糖尿病患病率及照护连续过程中的社会经济不平等。本研究利用了2016年和2021年伊朗STEPS调查的数据。糖尿病患病率及照护连续过程（包括知晓、治疗和血糖控制）依据实验室检测和自我报告数据予以界定。社会经济不平等通过基于回归的不平等斜率指数（SII）和不平等相对指数（RII）在财富和教育两个维度上进行估计。所有分析均纳入调查权重。本研究共纳入37，207名成年人（2016年19，113人，2021年18，094人）。在两个年份中，经年龄和性别调整的糖尿病患病率（2016年RII：0.65 [0.54-0.78]，2021年RII：0.68 [0.55-0.84]）和知晓率（2016年RII：0.88 [0.79-0.98]，2021年临界RII：0.88 [0.78-1.00]）均观察到显著的财富相关不平等。与2016年不同，2021年在各财富五分位组间观察到糖尿病治疗方面的显著差异（RII：0.82 [0.71-0.96]）。关于教育水平间的差异，调整模型显示2021年在实现良好血糖控制方面存在显著不平等（RII：0.77 [0.62-0.96]）。糖尿病患病率和知晓率方面的财富相关差异持续存在，且较富裕人群的患病率和知晓率不成比例地更高。2021年出现了新的差异：贫困人群的糖尿病治疗率较低，而受教育程度较低者的血糖控制较差。
Abstract
In Iran, the rising burden of diabetes and recent health system reforms underscore the need to assess inequalities across the diabetes care cascade. We evaluated socioeconomic inequalities in diabetes prevalence and care cascade in Iran. This study utilized data from the 2016 and 2021 Iran STEPS surveys. Diabetes prevalence and care cascade (including awareness, treatment, and glycemic control) were defined using laboratory and self-reported data. Socioeconomic inequalities were estimated using the regression-based slope index of inequality (SII) and the relative index of inequality (RII) across two dimensions of wealth and education. All analyses incorporated survey weights. A total number of 37,207 adults (19,113 in 2016 and 18,094 in 2021) were included in this study. In both years, significant wealth-related inequalities were observed in the age- and sex-adjusted diabetes prevalence (RII: 0.65 [0.54-0.78] in 2016 and RII: 0.68 [0.55-0.84] in 2021) and awareness (RII: 0.88 [0.79-0.98] in 2016 and a borderline RII: 0.88 [0.78-1.00] in 2021). In contrast to 2016, a significant disparity in diabetes treatment was observed across wealth quintiles in 2021 (RII: 0.82 [0.71-0.96]). Regarding disparities across educational levels, the adjusted model revealed a significant inequality in achieving fair glycemic control in 2021 (RII: 0.77 [0.62-0.96]). Wealth-related disparities in diabetes prevalence and awareness persisted, with prevalence and awareness disproportionately higher among the wealthier. New disparities emerged in 2021: the poor faced lower rates of diabetes treatment, while less-educated individuals exhibited poorer glycemic control.
如何引用
AMA
Sobhan Younesian, Seyede Maryam Mousavi, Vali Baygi, Nazila Rezaei, Sina Azadnajafabad, Ali Golestani. Socioeconomic inequalities in diabetes care cascade in Iran: STEPS 2016 and 2021.. Scientific reports. 2026; doi:10.1038/s41598-026-62354-0.
APA
Sobhan Younesian, Seyede Maryam Mousavi, Vali Baygi, Nazila Rezaei, Sina Azadnajafabad, Ali Golestani (2026). Socioeconomic inequalities in diabetes care cascade in Iran: STEPS 2016 and 2021.. Scientific reports. https://doi.org/10.1038/s41598-026-62354-0
GB/T 7714
Sobhan Younesian, Seyede Maryam Mousavi, Vali Baygi, Nazila Rezaei, Sina Azadnajafabad, Ali Golestani. Socioeconomic inequalities in diabetes care cascade in Iran: STEPS 2016 and 2021.[J]. Scientific reports, 2026 doi:10.1038/s41598-026-62354-0.
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