Association of household wealth and education level with hypertension and diabetes among adults in Bangladesh: a propensity score‐based analysis

Objective To determine the association of household wealth and education level with hypertension and diabetes in Bangladesh using propensity score (PS) analyses. Methods A nationally representative sample of the Bangladesh Demographic and Health Survey 2017–18 was analysed to explore the research question. A weighted sample of 11 320 individuals was considered. Hypertension and diabetes were the outcomes of interest, and household wealth status (non‐poor and poor) and education level (secondary/higher education and no secondary/higher education) were the exposure variables of interest. A person was defined as hypertensive if their average blood pressure was ≥140/90 mmHg or self‐reported history of taking antihypertensive medications. Individuals were classified as diabetic if they had a Fasting Blood Glucose level of ≥7 mmol/l or reported taking prescribed medication for reducing high blood glucose or diabetes. We used the 1:1 nearest neighbour PS matching without replacement and PS weighting approaches to assess the association between the exposures and the outcome variables. Results Wealth status was significantly associated with diabetes but not with hypertension, while education status was significantly associated with neither diabetes nor hypertension. We also observed a significant interaction effect between household wealth status and education level with diabetes. The odds of diabetes were approximately 60% higher among adults from non‐poor households and those without secondary/higher education. Conclusion Diabetes prevention and control programs should focus on non‐poor individuals, while hypertension prevention programs should target populations irrespective of educational attainment and wealth status.