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Interplay of regional economic development, income, gender and type 2 diabetes: evidence from half a million Chinese
  1. Kun Tang1,
  2. Hanyu Wang2,
  3. Yuning Liu3,
  4. Shi Hui Tan4
  1. 1 Research Center for Public Health, Tsinghua University, Beijing, China
  2. 2 Institute for Medical Humanities, Peking University Health Science Centre, Beijing, China
  3. 3 Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
  4. 4 School of Basic Medical Sciences, Peking University Health Science Centre, Beijing, China
  1. Correspondence to Dr Kun Tang, Research Center for Public Health, Tsinghua University, Beijing 100191, China; tangk{at}


Background Following the rapid economic growth, there has been a strong disparity of regional development and personal income in China. Type 2 diabetes mellitus (T2DM) may be influenced by socioeconomic status at both the societal and individual levels. This study examines the associations of regional economic development, household income and gender on T2DM.

Method Data from the baseline of a Chinese population-based study of approximately 500 000 adults from 10 areas were analysed. Clinically identified and screen-detected T2DM were examined. Regional economic development was indicated by gross domestic product (GDP) per capita. A logistic regression-based method was used to calculate the adjusted prevalence.

Result The prevalence of T2DM was significantly higher in medium GDP per capita areas for both males (7.04%, 95% CI 6.82% to 7.26%) and females (6.04%, 95% CI 5.86% to 6.22%) compared with areas of other levels of economic development. The different shapes of associations between household income and T2DM prevalence were observed in different GDP per capita areas. There were strong gender differences in terms of both the trend and strength of association between household income and T2DM prevalence.

Conclusions Findings from this study underscore the importance of economic conditions and gender difference on T2DM. It suggests that strategies for diabetes prevention should address social–economic differences besides a person-centred approach.

  • T2DM
  • GDP per capita
  • income
  • gender
  • health disparity
  • China

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  • KT and HW are joint first authors.

  • Contributors KT and HW contributed to the study concept and design, statistical analysis, results interpretation, drafting and revision of the manuscript and approved the final version of the manuscript. YL contributed to the study concept and design, and statistical analysis. ST contributed to the revision of the manuscript. KT is the guarantor of this work and, as such, had full access to all the data used in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Ethics approval This study has been approved by the Institutional Review Boards at Oxford University and the China National Center for Disease Control.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.