[Social determinants vs. lifestyle in type 2 diabetes mellitus in Andalusia (Spain): difficulty in making ends meet or obesity?].
OBJECTIVE
To assess the relationship between difficulty in making ends meet and obesity and type 2 diabetes mellitus in Andalusia.


METHODS
We performed a cross-sectional survey based on the Andalusian Health Survey-2003. Measures of the prevalence and odds ratios (OR) of type 2 diabetes mellitus were calculated according to lifestyle variables, obesity and type 2 diabetes mellitus according to self-perceived difficulties in making ends meet.


RESULTS
The age-adjusted OR of type 2 diabetes mellitus in obese individuals with respect to those with normal weight was 2.52 (95%CI: 1.63-3.88) in women and 2.13 (95%CI: 1.28-3.54) in men. A sedentary lifestyle was not related to a significant risk of type 2 diabetes mellitus in either sex. For women with greater difficulties in making ends meet compared with women with less difficulty, the risk of being obese, adjusted by age and physical exercise, was 3.03 (95%CI: 1.96-4.66), and the risk of having type 2 diabetes mellitus, adjusted by age, physical exercise and body mass index, was 2.55 (95%CI: 1.28-5.10). In men, none of the estimated OR was statistically significant.


CONCLUSIONS
For women, difficulties in making ends meet reflect a socio-economic context that contributes to a greater risk of obesity and type 2 diabetes mellitus. The gender and social inequalities identified could help to broaden the current framework of risks for type 2 diabetes mellitus, which is excessively focused on individual behaviors. Self-perceived difficulties in making ends meet could be useful as a poverty indicator in the study of inequalities in health.
Escolar Pujolar
Antonio
A
Delegación Provincial de Salud, Junta de Andalucía, Cádiz, Spain. antonio.escolar@uca.es
D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology