Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature

Renin Toms · Andrew D. Bonney · Darren John Mayne · Xiaoqi Feng · Ramya Walsan

36 citations0/0 files storedInternational Journal of Health Geographics

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Health disparities and outcomes Diabetes, Cardiovascular Risks, and Lipoproteins Public Health and Social Inequalities

Abstract

INTRODUCTION: A growing number of publications report variation in the distribution of cardiometabolic risk factors (CMRFs) at different geographic scales. A review of these variations may help inform policy and health service organisation. AIM: To review studies reporting variation in the geographic distribution of CMRFs and its association with various proxy measures of area-level socioeconomic disadvantage (ASED) among the adult ( ≥ 18 years) population across the world. METHODS: A systematic search for published articles was conducted in four databases (MEDLINE (Ovid), PubMed, Scopus and Web of Science) considering the interdisciplinary nature of the review question. Population-based cross-sectional and cohort studies on geographic variations of one or more biological proxies of CMRFs with/without an analysed contextual association with ASED were included. Two independent reviewers screened the studies and PRISMA guidelines were followed in the study selection and reporting. RESULT: A total of 265 studies were retrieved and screened, resulting in 24 eligible studies. The review revealed reports of variation in the distribution of CMRFs, at varying geographic scales, in multiple countries. In addition, consistent associations between ASED and higher prevalence of CMRFs were demonstrated. The reports were mainly from industrialised nations and small area geographic units were frequently used. CONCLUSION: Geographic variation in cardiometabolic risk exists across multiple spatial scales and is positively associated with ASED. This association is independent of individual-level factors and provides an imperative for area-based approaches to informing policy and health service organisation. The study protocol is registered in International prospective register of systematic reviews (Register No: CRD42018115294) PROSPERO 2018.

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1979A million or so correlation coefficients : three experiments on the modifiable areal unit problem 2010The influence of geographic life environments on cardiometabolic risk factors: a systematic review, a methodological assessment and a research agenda 2015Longitudinal Associations Between Neighborhood Physical and Social Environments and Incident Type 2 Diabetes Mellitus 2009Geographic Life Environments and Coronary Heart Disease: A Literature Review, Theoretical Contributions, Methodological Updates, and a Research Agenda 2012A Review of Spatial Methods in Epidemiology, 2000–2010 2009Modifiable Areal Unit Problem 2006Neighborhood deprivation and cardiovascular disease risk factors: Protective and harmful effects 2007Neighbourhood socioeconomic status and cardiovascular risk factors: a multilevel analysis of nine cities in the Czech Republic and Germany

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