Social distribution of diabetes, hypertension and related risk factors in Barbados: a cross-sectional study

Abstract

ObjectiveTo describe the distribution of diabetes, hypertension and related behavioural and biological risk factors in adults in Barbados by gender, education and occupation.DesignMultistage probability sampling was used to select a representative sample of the adult population (≥25 years). Participants were interviewed using standard questionnaires, underwent anthropometric and blood pressure measurements, and provided fasting blood for glucose and cholesterol measurements. Standard WHO definitions were used. Data were weighted for sampling and non-response, and were age and sex standardised to the 2010 Barbados population. Weighted prevalence estimates were calculated, and prevalence ratios were calculated for behavioural and biological risk factors by demographic and socioeconomic group.ResultsStudy response rate was 55.0%, with 764 women, 470 men. Prevalence of obesity was 33.8% (95% CI 30.7% to 37.1%); hypertension 40.6% (95% CI 36.5% to 44.9%); and diabetes 18.7% (95% CI 16.2% to 21.4%). Compared with women, men were less likely to be obese (prevalence ratio 0.5; 95% CI 0.4 to 0.7), or physically inactive (0.5; 0.4 to 0.6), but more likely to smoke tobacco (4.1; 2.5 to 6.7) and consume large amounts of alcohol in a single episode (4.6; 2.7 to 7.6). Both diabetes (0.83; 0.65 to 1.05) and hypertension (0.89; 0.79 to 1.02) were lower in men, but not significantly so. In women, higher educational level was related to higher fruit and vegetable intake, more physical activity, less diabetes and less hypercholesterolaemia (p 0.01–0.04). In men, higher education was related only to less smoking (p 0.04). Differences by occupation were limited to smoking in men and hypercholesterolaemia in women.ConclusionsIn this developing country population, sex appears to be a much stronger determinant of behavioural risk factors, as well as obesity and its related risks, than education or occupation. These findings have implications for meeting the commitments made in the 2011 Rio Political Declaration, to eliminate health inequities.

Association between socioeconomic status and prevalence of non-communicable diseases risk factors and comorbidities in Bangladesh: findings from a nationwide cross-sectional survey

“…In the current study, overweight/obesity and DM risk were greater among young people which is consistent with a similar study conducted in Indonesia 35. DM, HTN and overweight/obesity were more prevalent in non-manual labour compared with manual labour, which was similar to findings from a study in Barbados 36. However, the present study found males were more likely to suffer comorbidities than females, contradicting findings from previous studies 37 38.…”

Inducing remission of Type 2 diabetes in the Caribbean: findings from a mixed methods feasibility study of a low‐calorie liquid diet‐based intervention in Barbados

“…The underlying biology of the condition in this predominantly black population appears to be similar to that demonstrated in largely white European origin populations, although we acknowledge the desirability of further work to investigate the relationships between glucose metabolism and intrahepatic and intrapancreatic fat. The qualitative findings identified the serious challenges faced by participants of adhering to the low-calorie diet and subsequently maintaining weight loss in what is a highly obesogenic environment, where two in three adults are overweight or obese and one in five has diabetes [3]. Our findings highlight the importance of social support and self-efficacy in navigating this environment and can guide improvements in the design of the intervention.…”

“…Even if participants wished to substitute starchy carbohydrates with vegetables, these typically were unavailable or available in only small quantities. This lack of availability at least in part the high price of fruit and vegetables in Barbados [27] and the fact that only 10% of the general population report eating five or more portions per day [3].…”

“…The Caribbean population, predominantly of African origin, has overall rates of Type 2 diabetes among the highest in the world [1,2]. In Barbados, the prevalence of diabetes in adults aged 25 years and over was 18.7% (21.0% in women, 15.9% in men) in 2012; with an obesity prevalence of 33.8% (43.4% women; 23.4% men) [3].…”

The prevalence of peripheral neuropathy severe enough to cause a loss of protective sensation in a population‐based sample of people with known and newly detected diabetes in Barbados: a cross‐sectional study

“…This study examined a small sample of people from largely the same ethnic group and thus results may not be generalizable to other countries or ethnic groups. Although the response rate was 74% for this study, there was only a 55% response rate for the HotN study that identified the population with diabetes. This could affect the representativeness of the sample.…”