Social and behavioural risk factors in the prevention and management of cardiovascular disease in Kerala, India: a catchment area population survey.
Adult
Aged
Anxiety
/ epidemiology
Cardiovascular Diseases
/ diagnosis
Catchment Area, Health
Comorbidity
Cross-Sectional Studies
Depression
/ epidemiology
Diabetes Mellitus
/ diagnosis
Female
Health Behavior
Health Knowledge, Attitudes, Practice
Health Surveys
Heart Disease Risk Factors
Humans
Hypertension
/ diagnosis
India
/ epidemiology
Life Style
Male
Mental Health
Middle Aged
Prevalence
Protective Factors
Risk Assessment
Risk Reduction Behavior
Social Determinants of Health
Common mental health problems
Diabetes
Hypertension
India
Social risk
Journal
BMC cardiovascular disorders
ISSN: 1471-2261
Titre abrégé: BMC Cardiovasc Disord
Pays: England
ID NLM: 100968539
Informations de publication
Date de publication:
08 07 2020
08 07 2020
Historique:
received:
04
03
2020
accepted:
22
06
2020
entrez:
10
7
2020
pubmed:
10
7
2020
medline:
26
1
2021
Statut:
epublish
Résumé
Cardiovascular disease (CVD) is the leading cause of mortality in India. Social and behavioural factors are strongly interrelated in the prevention and control of CVD. The ability to make lifestyle changes to control hypertension and diabetes (major risk factors for CVD) is determined by factors such as education, gender, caste, poverty, and urbanicity. This study aimed to improve our understanding of the inter-relationship of social and behavioural factors in the management of elevated serum glucose and high blood pressure and co-morbid mental health conditions. A population-based catchment area cross sectional survey was conducted in Kerala, India. Data were collected from residents aged over 30 years (n = 997) using standardized tools and clinical measures. We performed latent class analysis incrementally to extract homogeneous latent classes of individuals based on their responses to social and behavioural risk factors in the survey. Using structural equation models, we assessed the mediating effect of depression and anxiety, and social or behavioural risk factors, on management of high blood pressure and raised serum glucose levels. The prevalence of high blood pressure and blood glucose in the sample was 33 and 26% respectively. Latent class analysis found three clusters of risk factors. One had a predominance of behavioural characteristics, another of social risk factors and the third was a low risk group. Age, female sex, and marital status had an effect on high blood pressure and high glucose, though were mediated by mental health, social and behavioural risk factors. Interventions to improve the management of risk factors for CVD need to address social risk factors and be sensitive to the needs of population sub-groups that may require additional support to access health services. An integration of social and health services may be required to achieve this.
Sections du résumé
BACKGROUND
Cardiovascular disease (CVD) is the leading cause of mortality in India. Social and behavioural factors are strongly interrelated in the prevention and control of CVD. The ability to make lifestyle changes to control hypertension and diabetes (major risk factors for CVD) is determined by factors such as education, gender, caste, poverty, and urbanicity. This study aimed to improve our understanding of the inter-relationship of social and behavioural factors in the management of elevated serum glucose and high blood pressure and co-morbid mental health conditions.
METHODS
A population-based catchment area cross sectional survey was conducted in Kerala, India. Data were collected from residents aged over 30 years (n = 997) using standardized tools and clinical measures. We performed latent class analysis incrementally to extract homogeneous latent classes of individuals based on their responses to social and behavioural risk factors in the survey. Using structural equation models, we assessed the mediating effect of depression and anxiety, and social or behavioural risk factors, on management of high blood pressure and raised serum glucose levels.
RESULTS
The prevalence of high blood pressure and blood glucose in the sample was 33 and 26% respectively. Latent class analysis found three clusters of risk factors. One had a predominance of behavioural characteristics, another of social risk factors and the third was a low risk group. Age, female sex, and marital status had an effect on high blood pressure and high glucose, though were mediated by mental health, social and behavioural risk factors.
CONCLUSIONS
Interventions to improve the management of risk factors for CVD need to address social risk factors and be sensitive to the needs of population sub-groups that may require additional support to access health services. An integration of social and health services may be required to achieve this.
Identifiants
pubmed: 32641078
doi: 10.1186/s12872-020-01595-x
pii: 10.1186/s12872-020-01595-x
pmc: PMC7346640
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
327Subventions
Organisme : World Health Organization
ID : 001
Pays : International
Organisme : UK-India Education and Research Initiative
ID : IND/CONT/G/16-17/74
Pays : International
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