Estimating diabetes prevalence by small area in England.
BACKGROUND: Diabetes risk is linked to both deprivation and ethnicity, and so prevalence will vary considerably between areas. Prevalence differences may partly account for geographic variation in health performance indicators for diabetes, which are based on age standardized hospitalization or oper...
| Publicado en: | Journal of Public Health Vol. 28; no. 1; pp. 71 - 82 |
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| Autor principal: | |
| Formato: | equations & formulas research tables/charts Journal Article |
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Oxford University Press / USA
Mar2006
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106371949&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106371949 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17413842 1CA0 jtl: Journal of Public Health issn: 17413842 maglogo: N pubinfo: dt: Mar2006 vid: 28 iid: 1 pid: 622 pub: Oxford University Press / USA artinfo: ui: 106371949 106371949 2009217388 10.1093/pubmed/fdi068 NLM16436450 106371949 ppf: 71 ppct: 11 formats: fmt: @attributes: type: P tig: atl: Estimating diabetes prevalence by small area in England. aug: au: Congdon P affil: Research Professor of Quantitative Geography & Health Statistics, Department of Geography, Queen Mary University of London, Mile End Road, London E1 4NS, UK; p.congdon@qmul.ac.uk sug: subj: Diabetes Mellitus, Type 1 Epidemiology Diabetes Mellitus, Type 2 Epidemiology Surveys Age Factors Diabetes Mellitus, Type 1 Ethnology Diabetes Mellitus, Type 1 Mortality Diabetes Mellitus, Type 2 Ethnology Diabetes Mellitus, Type 2 Mortality England Female Hospitalization Male Prevalence Secondary Analysis Sex Factors Human Female Male ab: BACKGROUND: Diabetes risk is linked to both deprivation and ethnicity, and so prevalence will vary considerably between areas. Prevalence differences may partly account for geographic variation in health performance indicators for diabetes, which are based on age standardized hospitalization or operation rates. A positive correlation between prevalence and health outcomes indicates that the latter are not measuring only performance. METHODS: A regression analysis of prevalence rates according to age, sex and ethnicity from the Health Survey for England (HSE) is undertaken and used (together with census data) to estimate diabetes prevalence for 354 English local authorities and 8000 smaller areas (electoral wards). An adjustment for social factors is based on a prevalence gradient over area-deprivation quintiles. A Bayesian estimation approach is used allowing simple inclusion of evidence on prevalence from other or historical sources. RESULTS: The estimated prevalent population in England is 1.5 million (188 000 type 1 and 1.341 million type 2). At strategic health authority (StHA) level, prevalence varies from 2.4 (Thames Valley) to 4 per cent (North East London). The prevalence estimates are used to assess variations between local authorities in adverse hospitalization indicators for diabetics and to assess the relationship between diabetes-related mortality and prevalence. In particular, rates of diabetic ketoacidosis (DKA) and coma are positively correlated with prevalence, while diabetic amputation rates are not. CONCLUSIONS: The methodology developed is applicable to developing small-area-prevalence estimates for a range of chronic diseases, when health surveys assess prevalence by demographic categories. In the application to diabetes prevalence, there is evidence that performance indicators as currently calculated are not corrected for prevalence. pubtype: Academic Journal doctype: equations & formulas research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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