Background The prevalence of diabetes has been shown to be socially patterned but the direction of the association in low-income countries and among migrant populations in Europe has varied in the literature. This study examined the association between socioeconomic position (SEP) and diabetes in Ghanaians in Europe and in Ghana.
Methods Data were derived from the multicentre Research on Obesity and Diabetes among African Migrants (RODAM) study of Ghanaian adults aged 25–70 years residing in Europe (Amsterdam, Berlin and London) and in urban and rural Ghana. Educational attainment (elementary, secondary or higher) and occupational class (low or high) were used as indicators of SEP. Age-standardised prevalence of diabetes and prevalence ratios were evaluated separately for men and women of different SEP in Ghana and Europe.
Results A total of 5290 participants were included in the analyses. The prevalence of diabetes decreased with increasing level of education in Ghanaian men and women in Europe and in men in urban Ghana, whereas diabetes prevalence increased with increasing level of education in men and women in rural Ghana. The association between occupational class and the prevalence of diabetes followed a less consistent pattern in men and women in the different locations.
Conclusions The association of diabetes and SEP differed in rural Ghana compared with urban settings in Ghana and Europe and comparing men and women, highlighting the complex interaction of SEP and the development of diabetes. These findings have important implications for diabetes prevention strategies in Ghanaians in different locations.
- Epidemiology of diabetes
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Contributors JA and LS planned the study. JA, AdGA, EB, KM, FPM and EOD conducted the data collection in the various locations and reported on the work presented. JA drafted the initial manuscript with intellectual input from CA, AdGA, EB, MBS, ID, CG, MN, KM, KKG, SB, FPM, EOD, AK and KS. JA submitted the study. JA and LS are responsible for the overall content as guarantors.
Funding This work was supported by the European Commission under the Framework Programme (Grant Number: 278901). LS's contribution was supported by the Wellcome Trust, grant number WT082178.
Disclaimer The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Competing interests None declared.
Ethics approval Ethics committees of the London School of Hygiene and Tropical Medicine, University of Amsterdam, University of Ghana, Kwame Nkrumah University of Science and Technology, University Medicine Berlin.
Provenance and peer review Not commissioned; externally peer reviewed.
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