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Grant Miller: Managerial Incentives in Public Service Delivery

Socioeconomic Gradients in Chronic Disease Risk Factors in Middle-Income Countries: Evidence of Effect Modification by Urbanicity in Argentina

Archived Abstract of Former PSC Researcher

Fleischer, N.L., Ana Diez Roux, M. Alazraqui, H. Spinelli, and F. De Maio. 2011. "Socioeconomic Gradients in Chronic Disease Risk Factors in Middle-Income Countries: Evidence of Effect Modification by Urbanicity in Argentina." American Journal of Public Health, 101(2): 294-301.

Objectives. We investigated associations of socioeconomic position (SEP) with chronic disease risk factors, and heterogeneity in this patterning by provincial-level urbanicity in Argentina. Methods. We used generalized estimating equations to determine the relationship between SEP and body mass index, high blood pressure, diabetes, low physical activity, and eating fruit and vegetables, and examined heterogeneity by urbanicity with nationally representative, cross-sectional survey data from 2005. All estimates were age adjusted and gender stratified. Results. Among men living in less urban areas, higher education was either not associated with the risk factors or associated adversely. In more urban areas, higher education was associated with better risk factor profiles (P<.05 for 4 of 5 risk factors). Among women, higher education was associated with better risk factor profiles in all areas and more strongly in more urban than in less urban areas (P<0.05 for 3 risk factors). Diet (in men) and physical activity (in men and women) were exceptions to this trend. Conclusions. These results provide evidence for the increased burden of chronic disease risk among those of lower SEP, especially in urban areas. (Am J Public Health. 2011;101:294-301. doi:10.2105/AJPH.2009.190165)

DOI:10.2105/ajph.2009.190165 (Full Text)

Country of focus: Argentina.

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