Diabetes, Hypertension, and Comorbidity among Bangladeshi Adults: Associated Factors and Socio-Economic Inequalities

Satyajit Kundu; Md Ashfikur Rahman; Humayun Kabir; Md Hasan Al Banna; John Elvis Hagan Jr; Medina Srem-Sai; Lina Wang

doi:10.3390/jcdd10010007

Diabetes, Hypertension, and Comorbidity among Bangladeshi Adults: Associated Factors and Socio-Economic Inequalities

J Cardiovasc Dev Dis. 2022 Dec 23;10(1):7. doi: 10.3390/jcdd10010007.

Authors

Satyajit Kundu¹, Md Ashfikur Rahman², Humayun Kabir^{3

4}, Md Hasan Al Banna⁵, John Elvis Hagan Jr^{6

7}, Medina Srem-Sai⁸, Lina Wang¹

Affiliations

¹ Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210096, China.
² Development Studies Discipline, Khulna University, Khulna 9208, Bangladesh.
³ Department of Public Health, North South University, Dhaka 1229, Bangladesh.
⁴ Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON L8S 4K1, Canada.
⁵ Department of Food Microbiology, Faculty of Nutrition and Food Science, Patuakhali Science and Technology University, Patuakhali 8602, Bangladesh.
⁶ Department of Health, Physical Education & Recreation, College of Education Studies, University of Cape Coast, Cape Coast PMB TF0494, Ghana.
⁷ Neurocognition and Action-Biomechanics-Research Group, Faculty of Psychology and Sports Science, Bielefeld University, 33501 Bielefeld, Germany.
⁸ Department of Health, Physical Education, Recreation and Sports, University of Education, Winneba P.O. Box 25, Ghana.

Abstract

Diabetes, hypertension, and comorbidity are still crucial public health challenges that Bangladeshis face. Nonetheless, very few studies have been conducted to examine the associated factors, especially the socioeconomic inequalities in diabetes, hypertension, and comorbidity in Bangladesh. This study explored the prevalence of, factors connected with, and socioeconomic inequalities in diabetes, hypertension, and comorbidity among Bangladeshi adults. We used the Bangladesh Demographic and Health Survey (BDHS) data set of 2017−2018. A total of 12,136 (weighted) Bangladeshi adults with a mean age of 39.5 years (±16.2) participated in this study. Multilevel (mixed-effect) logistic regression analysis was employed to ascertain the determinants of diabetes, hypertension, and comorbidity, where clusters were considered as a level-2 factor. The concentration curve (CC) and concentration index (CIX) were utilized to investigate the inequalities in diabetes, hypertension, and comorbidity. The weighted prevalence of diabetes, hypertension, and comorbidity was 10.04%, 25.70%, and 4.47%, respectively. Age, body mass index, physical activity, household wealth status, and diverse administrative divisions were significantly associated with diabetes, hypertension, and comorbidity among the participants. Moreover, participants’ smoking statuses were associated with hypertension. Women were more prone to hypertension and comorbidity than men. Diabetes (CIX: 0.251, p < 0.001), hypertension (CIX: 0.071, p < 0.001), and comorbidity (CIX: 0.340, p < 0.001) were higher among high household wealth groups. A pro-wealth disparity in diabetes, hypertension, and comorbidity was found. These inequalities in diabetes, hypertension, and comorbidity emphasize the necessity of designing intervention schemes geared towards addressing the rising burden of these diseases.

Keywords: Bangladesh; comorbidity; decomposition analysis; diabetes; hypertension; socioeconomic inequalities.

Grants and funding

The study received no external funding. However, the article processing charge (APC) was funded by Bielefeld University, Germany, through the Open Access Publication Fund.