Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients
SUMMARY Aims To investigate differences in metabolic control, access to healthcare, clinical outcomes and mortality rates in people from different cultural and ethnic backgrounds living in different geographical areas within central London. Methods Out of a cohort of 610 patients living within the...
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| Veröffentlicht in: | Diabetic medicine 2000-08, Vol.17 (8), p.612-617 |
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| creator | Weng, C. Coppini, D. V. Sönksen, P. H. |
| description | SUMMARY
Aims To investigate differences in metabolic control, access to healthcare, clinical outcomes and mortality rates in people from different cultural and ethnic backgrounds living in different geographical areas within central London.
Methods Out of a cohort of 610 patients living within the Greater London boundary and having a first visit to St Thomas' hospital in 1982–1985, 332 patients (54%) were reviewed in 1995, 186 patients (30%) died between 1982 and 1995 and 92 patients (16%) were lost to follow‐up. The patients' corresponding ‘electoral wards’ were ascertained in relation to postcodes of residence (Mapinfo). Each electoral ward has a Jarman ‘Underprivileged Area Score’ (UPA) so that patients can be clustered into prosperous, intermediate or deprived areas.
Results Patients living in deprived areas (n = 181) were older (61.3 years (95% confidence interval (CI) 59.5–63.1) vs. 58.6 years (95% CI 55.1–62.1), P = 0.01) and had a higher body mass index (29.2 kg/m2 (95% CI 28.4–30.0) vs. 25. 7 kg/m2 (95% CI 24.1–27.2), P = 0.003) and worse glycaemic control (HbA1 (%), 10.5 (95% CI 10.1–10.9) vs. 9.1 (95% CI 8.2–10.0), P = 0.003) than patients in prosperous areas (n = 59). Patients in deprived areas were more likely to be Caucasian (P |
| doi_str_mv | 10.1046/j.1464-5491.2000.00352.x |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_72403847</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>72403847</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3462-62c77e891e0b2318dc96ef38a80d7ab0fbcddc40f1b7b8729d29c0c5b4289d543</originalsourceid><addsrcrecordid>eNqNkM1u1DAUhS1ERYeWV0BZIHZJr38SxxIbaMsUqT-bIpbWje2Ah0wy2B4x8_Y4nVG7ZWUf-fvutQ4hBYWKgmguVhUVjShroWjFAKAC4DWrdq_I4vnhNVmAFKzkIOkpeRvjCoAyxdUbckopSE5bsSB-6aafATe_vClwtEWcjMeh6NGkKcQCgyuCGzA5W6Sp8KMJDmMO6yl03vq0f7JySjjMKWQ0Zq6wHjuX8tQNJu_GFM_JSY9DdO-O5xn5_vX68fKmvH1Yfrv8fFsaLhpWNsxI6VpFHXQs_9Ea1biet9iCldhB3xlrjYCedrJrJVOWKQOm7gRrla0FPyMfD3M3YfqzdTHptY_GDQOObtpGLZkA3gqZwfYAmjDFGFyvN8GvMew1BT3XrFd6blPPbeq5Zv1Us95l9f1xx7ZbO_siHnvNwIcjgNHg0AccjY8vXA2cqhn7dMD--sHt_3u_vrq7zpeslwfdx-R2zzqG37qRXNb6x_1Sq1p8ub-jTC_5P1XCqCo</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>72403847</pqid></control><display><type>article</type><title>Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients</title><source>MEDLINE</source><source>Access via Wiley Online Library</source><creator>Weng, C. ; Coppini, D. V. ; Sönksen, P. H.</creator><creatorcontrib>Weng, C. ; Coppini, D. V. ; Sönksen, P. H.</creatorcontrib><description>SUMMARY
Aims To investigate differences in metabolic control, access to healthcare, clinical outcomes and mortality rates in people from different cultural and ethnic backgrounds living in different geographical areas within central London.
Methods Out of a cohort of 610 patients living within the Greater London boundary and having a first visit to St Thomas' hospital in 1982–1985, 332 patients (54%) were reviewed in 1995, 186 patients (30%) died between 1982 and 1995 and 92 patients (16%) were lost to follow‐up. The patients' corresponding ‘electoral wards’ were ascertained in relation to postcodes of residence (Mapinfo). Each electoral ward has a Jarman ‘Underprivileged Area Score’ (UPA) so that patients can be clustered into prosperous, intermediate or deprived areas.
Results Patients living in deprived areas (n = 181) were older (61.3 years (95% confidence interval (CI) 59.5–63.1) vs. 58.6 years (95% CI 55.1–62.1), P = 0.01) and had a higher body mass index (29.2 kg/m2 (95% CI 28.4–30.0) vs. 25. 7 kg/m2 (95% CI 24.1–27.2), P = 0.003) and worse glycaemic control (HbA1 (%), 10.5 (95% CI 10.1–10.9) vs. 9.1 (95% CI 8.2–10.0), P = 0.003) than patients in prosperous areas (n = 59). Patients in deprived areas were more likely to be Caucasian (P < 0.005), and were less likely to be insulin‐treated (P = 0.004). Smoking was more prevalent in deprived areas (P = 0.02). The prevalence of microvascular complications was related to geographical location and the age–sex adjusted mortality rate was significantly higher in deprived than prosperous areas (2.6 vs. 1.91 per 100 person‐years).
Conclusions Environmental factors affect diabetes outcomes; increased morbidity and mortality rates in diabetic patients are related to socio‐economic and ethnic status.</description><identifier>ISSN: 0742-3071</identifier><identifier>EISSN: 1464-5491</identifier><identifier>DOI: 10.1046/j.1464-5491.2000.00352.x</identifier><identifier>PMID: 11073184</identifier><identifier>CODEN: DIMEEV</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Science Ltd</publisher><subject>Analysis. Health state ; Biological and medical sciences ; Cohort Studies ; Confidence Intervals ; Demography ; Diabetes Mellitus - epidemiology ; Diabetes Mellitus - mortality ; Diabetes Mellitus - physiopathology ; Diabetes Mellitus, Type 1 - epidemiology ; Diabetes Mellitus, Type 2 - epidemiology ; diabetes outcome ; Diabetic Foot - epidemiology ; Diabetic Neuropathies - epidemiology ; Diabetic Retinopathy - epidemiology ; environmental ; Epidemiology ; General aspects ; Glycated Hemoglobin A - analysis ; Humans ; London - epidemiology ; Medical sciences ; Middle Aged ; Morbidity ; mortality ; Poverty ; Poverty Areas ; Proteinuria - epidemiology ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; Retrospective Studies ; social deprivation ; Socioeconomic Factors</subject><ispartof>Diabetic medicine, 2000-08, Vol.17 (8), p.612-617</ispartof><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3462-62c77e891e0b2318dc96ef38a80d7ab0fbcddc40f1b7b8729d29c0c5b4289d543</citedby><cites>FETCH-LOGICAL-c3462-62c77e891e0b2318dc96ef38a80d7ab0fbcddc40f1b7b8729d29c0c5b4289d543</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1046%2Fj.1464-5491.2000.00352.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1046%2Fj.1464-5491.2000.00352.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,782,786,1419,27933,27934,45583,45584</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1503194$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11073184$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Weng, C.</creatorcontrib><creatorcontrib>Coppini, D. V.</creatorcontrib><creatorcontrib>Sönksen, P. H.</creatorcontrib><title>Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients</title><title>Diabetic medicine</title><addtitle>Diabet Med</addtitle><description>SUMMARY
Aims To investigate differences in metabolic control, access to healthcare, clinical outcomes and mortality rates in people from different cultural and ethnic backgrounds living in different geographical areas within central London.
Methods Out of a cohort of 610 patients living within the Greater London boundary and having a first visit to St Thomas' hospital in 1982–1985, 332 patients (54%) were reviewed in 1995, 186 patients (30%) died between 1982 and 1995 and 92 patients (16%) were lost to follow‐up. The patients' corresponding ‘electoral wards’ were ascertained in relation to postcodes of residence (Mapinfo). Each electoral ward has a Jarman ‘Underprivileged Area Score’ (UPA) so that patients can be clustered into prosperous, intermediate or deprived areas.
Results Patients living in deprived areas (n = 181) were older (61.3 years (95% confidence interval (CI) 59.5–63.1) vs. 58.6 years (95% CI 55.1–62.1), P = 0.01) and had a higher body mass index (29.2 kg/m2 (95% CI 28.4–30.0) vs. 25. 7 kg/m2 (95% CI 24.1–27.2), P = 0.003) and worse glycaemic control (HbA1 (%), 10.5 (95% CI 10.1–10.9) vs. 9.1 (95% CI 8.2–10.0), P = 0.003) than patients in prosperous areas (n = 59). Patients in deprived areas were more likely to be Caucasian (P < 0.005), and were less likely to be insulin‐treated (P = 0.004). Smoking was more prevalent in deprived areas (P = 0.02). The prevalence of microvascular complications was related to geographical location and the age–sex adjusted mortality rate was significantly higher in deprived than prosperous areas (2.6 vs. 1.91 per 100 person‐years).
Conclusions Environmental factors affect diabetes outcomes; increased morbidity and mortality rates in diabetic patients are related to socio‐economic and ethnic status.</description><subject>Analysis. Health state</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>Confidence Intervals</subject><subject>Demography</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Diabetes Mellitus - mortality</subject><subject>Diabetes Mellitus - physiopathology</subject><subject>Diabetes Mellitus, Type 1 - epidemiology</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>diabetes outcome</subject><subject>Diabetic Foot - epidemiology</subject><subject>Diabetic Neuropathies - epidemiology</subject><subject>Diabetic Retinopathy - epidemiology</subject><subject>environmental</subject><subject>Epidemiology</subject><subject>General aspects</subject><subject>Glycated Hemoglobin A - analysis</subject><subject>Humans</subject><subject>London - epidemiology</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Morbidity</subject><subject>mortality</subject><subject>Poverty</subject><subject>Poverty Areas</subject><subject>Proteinuria - epidemiology</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>Retrospective Studies</subject><subject>social deprivation</subject><subject>Socioeconomic Factors</subject><issn>0742-3071</issn><issn>1464-5491</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkM1u1DAUhS1ERYeWV0BZIHZJr38SxxIbaMsUqT-bIpbWje2Ah0wy2B4x8_Y4nVG7ZWUf-fvutQ4hBYWKgmguVhUVjShroWjFAKAC4DWrdq_I4vnhNVmAFKzkIOkpeRvjCoAyxdUbckopSE5bsSB-6aafATe_vClwtEWcjMeh6NGkKcQCgyuCGzA5W6Sp8KMJDmMO6yl03vq0f7JySjjMKWQ0Zq6wHjuX8tQNJu_GFM_JSY9DdO-O5xn5_vX68fKmvH1Yfrv8fFsaLhpWNsxI6VpFHXQs_9Ea1biet9iCldhB3xlrjYCedrJrJVOWKQOm7gRrla0FPyMfD3M3YfqzdTHptY_GDQOObtpGLZkA3gqZwfYAmjDFGFyvN8GvMew1BT3XrFd6blPPbeq5Zv1Us95l9f1xx7ZbO_siHnvNwIcjgNHg0AccjY8vXA2cqhn7dMD--sHt_3u_vrq7zpeslwfdx-R2zzqG37qRXNb6x_1Sq1p8ub-jTC_5P1XCqCo</recordid><startdate>200008</startdate><enddate>200008</enddate><creator>Weng, C.</creator><creator>Coppini, D. V.</creator><creator>Sönksen, P. H.</creator><general>Blackwell Science Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200008</creationdate><title>Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients</title><author>Weng, C. ; Coppini, D. V. ; Sönksen, P. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3462-62c77e891e0b2318dc96ef38a80d7ab0fbcddc40f1b7b8729d29c0c5b4289d543</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Analysis. Health state</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>Confidence Intervals</topic><topic>Demography</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Diabetes Mellitus - mortality</topic><topic>Diabetes Mellitus - physiopathology</topic><topic>Diabetes Mellitus, Type 1 - epidemiology</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>diabetes outcome</topic><topic>Diabetic Foot - epidemiology</topic><topic>Diabetic Neuropathies - epidemiology</topic><topic>Diabetic Retinopathy - epidemiology</topic><topic>environmental</topic><topic>Epidemiology</topic><topic>General aspects</topic><topic>Glycated Hemoglobin A - analysis</topic><topic>Humans</topic><topic>London - epidemiology</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Morbidity</topic><topic>mortality</topic><topic>Poverty</topic><topic>Poverty Areas</topic><topic>Proteinuria - epidemiology</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>Retrospective Studies</topic><topic>social deprivation</topic><topic>Socioeconomic Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Weng, C.</creatorcontrib><creatorcontrib>Coppini, D. V.</creatorcontrib><creatorcontrib>Sönksen, P. H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetic medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Weng, C.</au><au>Coppini, D. V.</au><au>Sönksen, P. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients</atitle><jtitle>Diabetic medicine</jtitle><addtitle>Diabet Med</addtitle><date>2000-08</date><risdate>2000</risdate><volume>17</volume><issue>8</issue><spage>612</spage><epage>617</epage><pages>612-617</pages><issn>0742-3071</issn><eissn>1464-5491</eissn><coden>DIMEEV</coden><abstract>SUMMARY
Aims To investigate differences in metabolic control, access to healthcare, clinical outcomes and mortality rates in people from different cultural and ethnic backgrounds living in different geographical areas within central London.
Methods Out of a cohort of 610 patients living within the Greater London boundary and having a first visit to St Thomas' hospital in 1982–1985, 332 patients (54%) were reviewed in 1995, 186 patients (30%) died between 1982 and 1995 and 92 patients (16%) were lost to follow‐up. The patients' corresponding ‘electoral wards’ were ascertained in relation to postcodes of residence (Mapinfo). Each electoral ward has a Jarman ‘Underprivileged Area Score’ (UPA) so that patients can be clustered into prosperous, intermediate or deprived areas.
Results Patients living in deprived areas (n = 181) were older (61.3 years (95% confidence interval (CI) 59.5–63.1) vs. 58.6 years (95% CI 55.1–62.1), P = 0.01) and had a higher body mass index (29.2 kg/m2 (95% CI 28.4–30.0) vs. 25. 7 kg/m2 (95% CI 24.1–27.2), P = 0.003) and worse glycaemic control (HbA1 (%), 10.5 (95% CI 10.1–10.9) vs. 9.1 (95% CI 8.2–10.0), P = 0.003) than patients in prosperous areas (n = 59). Patients in deprived areas were more likely to be Caucasian (P < 0.005), and were less likely to be insulin‐treated (P = 0.004). Smoking was more prevalent in deprived areas (P = 0.02). The prevalence of microvascular complications was related to geographical location and the age–sex adjusted mortality rate was significantly higher in deprived than prosperous areas (2.6 vs. 1.91 per 100 person‐years).
Conclusions Environmental factors affect diabetes outcomes; increased morbidity and mortality rates in diabetic patients are related to socio‐economic and ethnic status.</abstract><cop>Oxford, UK</cop><pub>Blackwell Science Ltd</pub><pmid>11073184</pmid><doi>10.1046/j.1464-5491.2000.00352.x</doi><tpages>6</tpages></addata></record> |
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| subjects | Analysis. Health state Biological and medical sciences Cohort Studies Confidence Intervals Demography Diabetes Mellitus - epidemiology Diabetes Mellitus - mortality Diabetes Mellitus - physiopathology Diabetes Mellitus, Type 1 - epidemiology Diabetes Mellitus, Type 2 - epidemiology diabetes outcome Diabetic Foot - epidemiology Diabetic Neuropathies - epidemiology Diabetic Retinopathy - epidemiology environmental Epidemiology General aspects Glycated Hemoglobin A - analysis Humans London - epidemiology Medical sciences Middle Aged Morbidity mortality Poverty Poverty Areas Proteinuria - epidemiology Public health. Hygiene Public health. Hygiene-occupational medicine Retrospective Studies social deprivation Socioeconomic Factors |
| title | Geographic and social factors are related to increased morbidity and mortality rates in diabetic patients |
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