Socio-economic inequalities in the chronic diseases management among Chinese adults aged 45 years and above: a cross sectional study

Arch Public Health. 2021 Aug 30;79(1):157. doi: 10.1186/s13690-021-00678-1.

Abstract

Backgrounds: Non-communicable diseases (NCDs) have become a priority public health issue. The aim of this study was to examine whether socio-economic inequalities exist in chronic disease management among Chinese adults, and whether the relationship between SES and chronic disease management mediated by social capital.

Methods: We used combined data from China Health and Retirement Longitudinal Study (CHARLS). A total of 19,291 subjects, including 14,905 subjects from 2011 survey, 2036 subjects from 2013, and 2350 subjects from 2015 was included in this study.

Results: Subjects living in urban setting, with higher education attainment and economic status were more likely to have annual health checks, and to be diagnosed for those with hypertension, diabetes and dyslipidemia (all P < 0.05). Social participation could mediate the association between social economic status (SES) and annual health checks, diagnosis of hypertension and dyslipidemia, and health education of hypertension. Health checks could mediate the association between social participation and the diagnosis of hypertension, diabetes and dyslipidemia. The proportions of mediation were 17.5, 23.9 and 8.9%, respectively. There were no mediating effects observed from cognitive social capital variable-perceived helpfulness.

Conclusion: It is necessary to deeply reform our social security system and enhance the social capital construction to promote those low SES people's physical health.

Keywords: Chronic disease; Inequalities; Social capital; Socio-economic.