Explaining income-related inequalities in cardiovascular risk factors in Tunisian adults during the last decade: comparison of sensitivity analysis of logistic regression and Wagstaff decomposition analysis



Saidi, Olfa, Zoghlami, Nada, Bennett, Kathleen E, Mosquera, Paola Andrea, Malouche, Dhafer, Capewell, Simon ORCID: 0000-0003-3960-8999, Ben Romdhane, Habiba and O'Flaherty, Martin ORCID: 0000-0001-8944-4131
(2019) Explaining income-related inequalities in cardiovascular risk factors in Tunisian adults during the last decade: comparison of sensitivity analysis of logistic regression and Wagstaff decomposition analysis. INTERNATIONAL JOURNAL FOR EQUITY IN HEALTH, 18 (1). 177-.

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Abstract

<h4>Background</h4>It is important to quantify inequality, explain the contribution of underlying social determinants and to provide evidence to guide health policy. The aim of the study is to explain the income-related inequalities in cardiovascular risk factors in the last decade among Tunisian adults aged between 35 and 70 years old.<h4>Methods</h4>We performed the analysis by applying two approaches and compared the results provided by the two methods. The methods were global sensitivity analysis (GSA) using logistic regression models and the Wagstaff decomposition analysis.<h4>Results</h4>Results provided by the two methods found a higher risk of cardiovascular diseases and diabetes in those with high socio-economic status in 2005. Similar results were observed in 2016. In 2016, the GSA showed that education level occupied the first place on the explanatory list of factors explaining 36.1% of the adult social inequality in high cardiovascular risk, followed by the area of residence (26.2%) and income (15.1%). Based on the Wagstaff decomposition analysis, the area of residence occupied the first place and explained 40.3% followed by income and education level explaining 19.2 and 14.0% respectively. Thus, both methods found similar factors explaining inequalities (income, educational level and regional conditions) but with different rankings of importance.<h4>Conclusions</h4>The present study showed substantial income-related inequalities in cardiovascular risk factors and diabetes in Tunisia and provided explanations for this. Results based on two different methods similarly showed that structural disparities on income, educational level and regional conditions should be addressed in order to reduce inequalities.

Item Type: Article
Uncontrolled Keywords: Social inequalities, Global sensitivity analysis (GSA), Logistic regression, Wagstaff-type decomposition analysis, Diabetes, Cardiovascular risk factors, Tunisia
Depositing User: Symplectic Admin
Date Deposited: 25 Nov 2019 16:11
Last Modified: 19 Jan 2023 00:19
DOI: 10.1186/s12939-019-1047-6
Open Access URL: https://equityhealthj.biomedcentral.com/articles/1...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3063436