Prevalence of chronic diseases according to socioeconomic status measured by wealth index: health survey in Serbia.

AIM To examine socioeconomic inequalities in the prevalence of chronic diseases in Serbia, using the data from 2006 national health survey. METHOD A stratified sample of 7673 households was selected and 14522 household members older than 20 years were interviewed (response rate 80.5%). Wealth index was used as a measure of socioeconomic status. Standardized morbidity prevalence ratios were computed using the poorest category as reference. Odds ratios for the prevalence of the selected chronic diseases and their 95% confidence intervals were calculated by multivariate logistic analysis adjusted for age, education, smoking status, and body mass index. RESULTS Hypertension was the most prevalent disease in all socioeconomic categories; standardized morbidity prevalence ratios were higher in richer men (151.3 in the richest) and lower in richer women (86.1 in the richest). Rheumatism/arthritis was the second most prevalent disease in both sexes, with the highest prevalence in the poorest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 86.4 in men and 74.0 in women). The prevalence of hyperlipidemia was associated with wealth index in both men and women and was highest in the richest group; the pattern remained the same after standardization (standardized morbidity prevalence ratio in the richest: 275.9 in men and 138.4 in women). Logistic regression models showed that higher wealth index was associated with higher prevalence of hypertension, hyperlipidemia, and allergy, while lower wealth index was associated with higher prevalence of rheumatism/arthritis. CONCLUSION There were considerable socioeconomic inequalities in the prevalence of chronic diseases in Serbia. These results indicate an opportunity to reduce inequalities and show a need for further investigation on the determinants of chronic diseases.

[1]  A. Mielck,et al.  Trends in socioeconomic inequalities in self-assessed health in 10 European countries. , 2005, International journal of epidemiology.

[2]  M. Gragnolati,et al.  The Impoverishing Effect of Adverse Health Events: Evidence from the Western Balkans , 2007 .

[3]  D. Hatsukami,et al.  Craving, withdrawal, and smoking urges on days immediately prior to smoking relapse. , 2008, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[4]  Kiersten B. Johnson,et al.  The DHS wealth index , 2004 .

[5]  K. Stronks,et al.  Validation of cancer prevalence data from a postal survey by comparison with cancer registry records. , 1994, American journal of epidemiology.

[6]  J. Mackenbach,et al.  Class-related health inequalities are not larger in the East: a comparison of four European regions using the new European socioeconomic classification , 2008, Journal of Epidemiology & Community Health.

[7]  M. C. Leske,et al.  Comparing self-reported and physician-reported medical history. , 1994, American journal of epidemiology.

[8]  A. Kunst Describing socioeconomic inequalities in health in European countries: an overview of recent studies. , 2007, Revue d'epidemiologie et de sante publique.

[9]  N. Goldman,et al.  Socioeconomic differences in health among older adults in Mexico. , 2007, Social science & medicine.

[10]  L. Rushton,et al.  Lifestyle surveys--the complete answer? , 1997, Journal of epidemiology and community health.

[11]  J. Mackenbach,et al.  Socioeconomic inequalities in health in 22 European countries. , 2008, The New England journal of medicine.

[12]  Zoe Oldfield,et al.  Disease and disadvantage in the United States and in England. , 2006, JAMA.

[13]  N. Adler,et al.  Blood pressure and socioeconomic status in low-income women in Mexico: a reverse gradient? , 2008, Journal of Epidemiology & Community Health.

[14]  A. Kunst,et al.  Social inequalities in health care services utilisation after eight years of health care reforms: a cross-sectional study of Estonia, 1999. , 2005, Social science & medicine.

[15]  H. Oyen,et al.  Socioeconomic inequalities in lung cancer mortality in 16 European populations. , 2009, Lung cancer.

[16]  A. Rosengren,et al.  Heart failure in different occupational classes in Sweden. , 2006, European heart journal.

[17]  M. Marmot,et al.  Socio-economic status over the life-course and depressive symptoms in men and women in Eastern Europe. , 2008, Journal of affective disorders.

[18]  G. Mensah,et al.  Socioeconomic status and trends in disparities in 4 major risk factors for cardiovascular disease among US adults, 1971-2002. , 2006, Archives of internal medicine.

[19]  C. Pollack,et al.  Should health studies measure wealth? A systematic review. , 2007, American journal of preventive medicine.

[20]  C Borrell,et al.  Socioeconomic differences in the prevalence of common chronic diseases: an overview of eight European countries. , 2005, International journal of epidemiology.

[21]  P Boffetta,et al.  Socioeconomic differences in cancer incidence and mortality. , 1997, IARC scientific publications.

[22]  M. Marmot,et al.  BMC Public Health BioMed Central Study protocol , 2006 .

[23]  S. Demarest,et al.  Survey error in measuring socio-economic risk factors of health status: a comparison of a survey and a census. , 2007, International journal of epidemiology.