title: Multilevel Analysis of Socioeconomic Determinants on Diabetes Prevalence, Awareness, Treatment and Self-Management in Ethnic Minorities of Yunnan Province, China.
abstract: The objective of this manuscript is to investigate socioeconomic differences in prevalence, awareness, treatment and self-management of diabetes among ethnic minority groups in Yunnan Province, China.
  
  
  
  We conducted a cross-sectional survey in a sample of 5532 Na Xi, Li Su, Dai and Jing Po ethnic minorities. Multilevel modeling was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for diabetes prevalence, as well as the other outcomes.
  
  
  
  Higher individual educational level was associated with a higher rate of awareness, treatment, adherence to medicines and monitoring of blood glucose (OR = 1.87, 4.89, 4.83, 6.45; 95% CI: 1.26-2.77, 1.87-12.7, 1.95-11.9, 2.23-18.6, respectively). Diabetic respondents with better household assets tended to receive more treatment (OR = 2.81, 95% CI: 1.11-7.12) and to monitor their blood glucose (OR = 3.29, 95% CI: 1.48-7.30). Diabetic patients with better access to medical services were more likely to treat (OR = 7.09, 95% CI: 2.46-20.4) and adhere to medication (OR = 4.14, 95% CI: 1.46-11.7). Income at the contextual level was significantly correlated with diabetes prevalence, treatment and blood glucose monitoring (OR = 1.84, 3.04, 4.34; 95% CI: 1.20-2.83, 1.20-7.73, 1.45-13.0, respectively).
  
  
  
  Future diabetes prevention and intervention programs should take both individual and township-level socioeconomic factors into account in the study regions.
authors.affiliation: School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China. surong.endure@163.com.|Department of Gerontology, The Affiliated Ganmei Hospital of Kunming Medical University, 504 Qing Nian Road, Kunming 650011, China. surong.endure@163.com.
authors.forename: Rong
authors.initials: R
authors.lastname: Su
authors.affiliation: School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China. caile002@hotmail.com.
authors.forename: Le
authors.initials: L
authors.lastname: Cai
authors.affiliation: School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China. cuiwenlong972@126.com.
authors.forename: Wenlong
authors.initials: W
authors.lastname: Cui
authors.affiliation: School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China. hejianhui9804012@163.com.
authors.forename: Jianhui
authors.initials: J
authors.lastname: He
authors.affiliation: School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China. youdinyun_km@163.com.
authors.forename: Dingyun
authors.initials: D
authors.lastname: You
authors.affiliation: School of Public Health, Kunming Medical University, 1168 Yu Hua Street, Chun Rong Road, Cheng Gong New City, Kunming 650500, China. agoldena@outlook.com.
authors.forename: Allison
authors.initials: A
authors.lastname: Golden
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D005006:Ethnicity; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012648:Self Care; D012959:Socioeconomic Factors
chemical_list: D001786:Blood Glucose
keywords: diabetes; multilevel modeling; prevalence; self-management; socioeconomic status; unique ethnic minority