Social inequality in prevalence of NCD risk factors: a cross-sectional analysis from the population-based Tromsø Study 2015–2016

• Published in: BMJ Open
• Main Authors: Hetland, Rebecca A, Wilsgaard, Tom, Hopstock, Laila Arnesdatter, Ariansen, Inger, Johansson, Jonas, Jacobsen, Bjarne K, Grimsgaard, Sameline
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2024
• Subjects: Tromsø
• Online Access: http://dx.doi.org/10.1136/bmjopen-2023-080611; https://syndication.highwire.org/content/doi/10.1136/bmjopen-2023-080611

Objective We aimed to examine associations between educational level, serving as an indicator of socioeconomic position, and prevalence of WHO-established leading behavioural and biological risk factors for non-communicable diseases (NCDs), in middle-aged to older women and men. Design Population-based cross-sectional study. Setting All inhabitants of the municipality of Tromsø, Norway, aged ≥40 years, were invited to the seventh survey (2015–2016) of the Tromsø Study; an ongoing population-based cohort study. Participants Of the 32 591 invited; 65% attended, and a total of 21 069 women (53%) and men aged 40–99 years were included in our study. Outcome measures We assessed associations between educational level and NCD behavioural and biological risk factors: daily smoking, physical inactivity (sedentary in leisure time), insufficient fruit/vegetable intake (<5 units/day), harmful alcohol use (>10 g/day in women, >20 g/day in men), hypertension, obesity, intermediate hyperglycaemia and hypercholesterolaemia. These were expressed as odds ratios (OR) per unit decrease in educational level, with 95% CIs, in women and men. Results In women (results were not significantly different in men), we observed statistically significant associations between lower educational levels and higher odds of daily smoking (OR 1.69; 95% CI 1.60 to 1.78), physical inactivity (OR 1.38; 95% CI 1.31 to 1.46), insufficient fruit/vegetable intake (OR 1.54, 95% CI 1.43 to 1.66), hypertension (OR 1.25; 95% CI 1.20 to 1.30), obesity (OR 1.23; 95% CI 1.18 to 1.29), intermediate hyperglycaemia (OR 1.12; 95% CI 1.06 to 1.19), and hypercholesterolaemia (OR 1.07; 95% CI 1.03 to 1.12), and lower odds of harmful alcohol use (OR 0.75; 95% CI 0.72 to 0.78). Conclusion We found statistically significant educational gradients in women and men for all WHO-established leading NCD risk factors within a Nordic middle-aged to older general population. The prevalence of all risk factors increased at lower educational levels, except for harmful alcohol ...