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The impact of regional deprivation and individual socio-economic status on the prevalence of Type 2 diabetes in Germany. A pooled analysis of five population-based studies

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Published:25th Mar 2020
Aim: Our objective was to test the hypothesis that the prevalence of Type 2 diabetes increases with increasing regional deprivation even after controlling for individual socio-economic status. Methods: We pooled cross-sectional data from five German population-based studies. The data set contained information on n = 11 688 study participants (men 50.1%) aged 45�74 years, of whom 1008 people had prevalent Type 2 diabetes (men 56.2%). Logistic multi-level regression was performed to estimate odds ratios and 95% confidence intervals for diabetes prevalence. We controlled for sex, age and lifestyle risk factors, individual socio-economic status and regional deprivation, based on a new small-area deprivation measure, the German Index of Multiple Deprivation. Results: Adjusted for sex, age, BMI, physical activity, smoking status and alcohol consumption, the prevalence of Type 2 diabetes showed a stepwise increase in risk with increasing area deprivation [odds ratio 1.88 (95% CI 1.16�3.04) in quintile 4 and odds ratio 2.14 (95% CI 1.29�3.55) in quintile 5 compared with the least deprived quintile 1], even after controlling for individual socio-economic status. Focusing on individual socio-economic status alone, the risk of having diabetes was significantly higher for low compared with medium or high educational level [odds ratio 1.46 (95% CI 1.24�1.71)] and for the lowest compared with the highest income group [odds ratio 1.53 (95% CI 1.18�1.99)]. Conclusion: Regional deprivation plays a significant part in the explanation of diabetes prevalence in Germany independently of individual socio-economic status. The results of the present study could help to target public health measures in deprived regions.

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