Association of socioeconomic and lifestyle factors with prevalence of diabetes in rural southwest China: a structural equation modelling approach

Abstract

Objectives This study aimed to investigate the prevalence of diabetes using structural equation modelling (SEM) to examine the pathways and associations of socioeconomic and lifestyle factors on diabetes in rural southwest China.Design Data were collected from a cross-sectional health interview and examination survey among individuals aged ≥35 years in rural southwest China. Fasting blood glucose, blood pressure, height, weight and waist circumference (WC) were measured for each participant. SEM was employed to assess the relationships between demographic characteristics (sex, age and ethnicity), socioeconomic position (SEP; annual household income, education level and access to medical services), lifestyle factors (obesity status (body mass index and WC) and physical inactivity), hypertension, hyperlipidaemia and family history of diabetes.Setting This study was conducted in rural Yunnan Province of China.Participants 7536 individuals aged ≥35 years consented to participate in the study.Results The overall prevalence of diabetes in the present study was 8.3%. Prevalence did not differ by gender (prevalence for both men and women was 8.3% (p>0.05)). The results of SEM indicated that SEP, age, ethnicity, obesity status and physical inactivity had both significant direct and indirect effects on diabetes, with total effect size of 0.091, 0.149, –0.094, 0.212 and 0.089, respectively (p<0.01). Family history of diabetes (0.128, p<0.01), hypertension (0.135, p<0.01) and hyperlipidaemia (0.137, p<0.01) were directly associated with diabetes.Conclusions Socioeconomic and lifestyle factors have both direct and indirect effects on prevalence of diabetes in rural southwest China. Future efforts to implement comprehensive interventions to promote the prevention and control of diabetes should in particular focus on obese individuals.