PMID- 34810190
OWN - NLM
STAT- MEDLINE
DCOM- 20211206
LR  - 20220716
IS  - 2044-6055 (Electronic)
IS  - 2044-6055 (Linking)
VI  - 11
IP  - 11
DP  - 2021 Nov 22
TI  - Quantification of disparities in the distribution of lifestyle and metabolic risk 
      factors, prevalence of non-communicable diseases and related mortality: the 
      Belgian Health Interview Surveys 1997-2018.
PG  - e053260
LID - 10.1136/bmjopen-2021-053260 [doi]
LID - e053260
AB  - OBJECTIVES: Comprehensively measure the trends in health disparities by 
      sociodemographic strata in terms of exposure to lifestyle and metabolic risks, 
      and prevalence and mortality of non-communicable diseases (NCDs) during the last 
      20 years in Belgium. DESIGN: Cross-sectional analysis of periodic 
      national-representative health interview surveys and vital statistics. SETTING: 
      Population-based study of adult residents in Belgium between 1997 and 2018. 
      PARTICIPANTS: Adults aged 25-84 years and resident in Belgium in the years 1997 
      (7256 adults), 2001 (8665), 2004 (9054), 2008 (7343), 2013 (7704) and 2018 
      (8358). MAIN OUTCOME MEASURE: Age-standardised prevalence rates of modifiable 
      lifestyle risks (poor diet, smoking, excessive alcohol use and leisure-time 
      physical inactivity), metabolic risks (high body mass index (BMI), blood pressure 
      and cholesterol levels) and major NCDs (type 2 diabetes mellitus (T2DM), 
      cardiovascular diseases (CVDs), cancer, asthma and chronic obstructive pulmonary 
      disease (COPD)), with their relative health disparities across strata by age, 
      sex, region of residence, nationality, education and income level, and according 
      to high versus low engagement in the four lifestyle risks, calculated from a 
      survey-weighted age-adjusted logistic regression. RESULTS: Greater avoidable 
      disparities were observed between extremes of education and income strata. The 
      most marked disparities were found for exposure to lifestyle risks (except 
      excessive alcohol use), prevalence of high BMI as well as T2DM, asthma and COPD, 
      with disparities of daily smoking and COPD worsening over time. Still, 
      NCD-specific mortality rates were significantly higher among men (except asthma), 
      residents of Wallonia and Brussels (except cerebrovascular disease), and among 
      the native Belgians (except T2DM and asthma). High engagement in lifestyle risks 
      was generally observed for men, residents of the region Wallonia, and among lower 
      education and income strata. This subgroup (20%) had a worse health profile as 
      compared with those who had a low-risk lifestyle (25%), shown by prevalence 
      ratios varying between 1.1 and 1.6 for metabolic risks, and between 1.8 and 3.7 
      for CVD, asthma and COPD. CONCLUSIONS: Improving population health, including 
      promoting greater health equity, requires approaches to be tailored to high-risk 
      groups with actions tackling driving root causes of disparities seen by social 
      factors and unhealthy lifestyle.
CI  - (c) Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Mertens, Elly
AU  - Mertens E
AUID- ORCID: 0000-0003-4957-4235
AD  - Unit of Non-Communicable Diseases, Department of Public Health, Institute of 
      Tropical Medicine, Antwerp, Belgium ellymertens@itg.be.
FAU - Sagastume, Diana
AU  - Sagastume D
AD  - Unit of Non-Communicable Diseases, Department of Public Health, Institute of 
      Tropical Medicine, Antwerp, Belgium.
FAU - Penalvo, Jose L
AU  - Penalvo JL
AUID- ORCID: 0000-0003-0096-6238
AD  - Unit of Non-Communicable Diseases, Department of Public Health, Institute of 
      Tropical Medicine, Antwerp, Belgium.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20211122
PL  - England
TA  - BMJ Open
JT  - BMJ open
JID - 101552874
SB  - IM
MH  - Adult
MH  - Belgium/epidemiology
MH  - Cross-Sectional Studies
MH  - *Diabetes Mellitus, Type 2
MH  - Health Surveys
MH  - Humans
MH  - Life Style
MH  - Male
MH  - *Noncommunicable Diseases/epidemiology
MH  - Prevalence
MH  - Risk Factors
PMC - PMC8609944
OTO - NOTNLM
OT  - epidemiology
OT  - nutrition & dietetics
OT  - public health
COIS- Competing interests: None declared.
EDAT- 2021/11/24 06:00
MHDA- 2021/12/15 06:00
PMCR- 2021/11/21
CRDT- 2021/11/23 05:53
PHST- 2021/11/23 05:53 [entrez]
PHST- 2021/11/24 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/11/21 00:00 [pmc-release]
AID - bmjopen-2021-053260 [pii]
AID - 10.1136/bmjopen-2021-053260 [doi]
PST - epublish
SO  - BMJ Open. 2021 Nov 22;11(11):e053260. doi: 10.1136/bmjopen-2021-053260.