Journal Article

Geographic and area-level socioeconomic variation in cardiometabolic risk factor distribution: a systematic review of the literature

Mayne, Darren J., Walsan, Ramya, Feng, Xiaoqi, Toms, Renin, Bonney, Andrew

2019

Overview

Introduction A growing number of publications report variation in the distribution of cardiometabolic risk factors (CMRFs) at different geographic scales. A review of these variations may help inform policy and health service organisation. Aim To review studies reporting variation in the geographic distribution of CMRFs and its association with various proxy measures of area-level socioeconomic disadvantage (ASED) among the adult ( ≥ 18 years) population across the world. Methods A systematic search for published articles was conducted in four databases (MEDLINE (Ovid), PubMed, Scopus and Web of Science) considering the interdisciplinary nature of the review question. Population-based cross-sectional and cohort studies on geographic variations of one or more biological proxies of CMRFs with/without an analysed contextual association with ASED were included. Two independent reviewers screened the studies and PRISMA guidelines were followed in the study selection and reporting. Result A total of 265 studies were retrieved and screened, resulting in 24 eligible studies. The review revealed reports of variation in the distribution of CMRFs, at varying geographic scales, in multiple countries. In addition, consistent associations between ASED and higher prevalence of CMRFs were demonstrated. The reports were mainly from industrialised nations and small area geographic units were frequently used. Conclusion Geographic variation in cardiometabolic risk exists across multiple spatial scales and is positively associated with ASED. This association is independent of individual-level factors and provides an imperative for area-based approaches to informing policy and health service organisation. The study protocol is registered in International prospective register of systematic reviews (Register No: CRD42018115294) PROSPERO 2018.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Analysis / Area-level socioeconomic disadvantage / Body mass index / Cardiometabolic risk factors / Cardiovascular disease / Cardiovascular diseases / Cardiovascular Diseases - diagnosis / Cardiovascular Diseases - economics / Cardiovascular Diseases - epidemiology / Cross-Sectional Studies / Diabetes / Economic aspects / Epidemiology / Geographic information systems / Geographic Mapping / Geographic variation / Geographical distribution / Geographical variations / Geography / Health Informatics / Health Promotion and Disease Prevention / Health risks / Health screening / Health services / Human Geography / Humans / Interdisciplinary aspects / Literature reviews / Medical Geography / Medicine / Medicine & Public Health / Metabolic diseases / Metabolism / Mortality / Population / Proxies / Proxy / Public Health / Review / Risk analysis / Risk Factors / Social aspects / Socioeconomic Factors / Socioeconomics / Spatial distribution / Studies / Systematic review