Socioeconomic determinants of non-communicable-diseases among the Cypriot population: questionnaire study

OBJECTIVE To investigate the extent to which the socioeconomic status of Cypriots is associated with the lifetime prevalence of self-reported non-communicable disease (NCDs), with emphasis on those accounting for most Death and Disability-adjusted Life Years (DALYs) among the population, including cardiovascular disease (CVD), metabolic risks and neuropsychiatric disorders. DESIGN A nationally based survey conducted through personal interviews, using a structured questionnaire design. SETTING Cyprus rural and urban areas (excluding Turkish-occupied areas). PARTICIPANTS Four hundred and sixty-five Cypriot adults of an average age of 53 years. MAIN OUTCOME MEASURES Lifetime prevalence of self-reported NCDs. RESULTS Most self-reported NCDs were shown to have significant associations with socioeconomic status, defined for this study by level of education and family income. Education was significantly inversely associated with CVD (18.1% at elementary education level (EE); 2.7% at high school education level (HE); and 1.7% at University/College education level (UE)), hypertension (23.4% at EE; 8.6% at HE; and 2.6% at UE), hypercholesterolaemia (12.8% at EE; 7.1% at HE; and 5.2% at UE), obesity (10.7% at EE; 4.7% at HE; and 3.5% at UE), diabetes (13.8% at EE; 2.4% at HE; and 0.9% at UE), and drug addiction (7.6% at EE; 1.6% at HE; and 0.0% at UE). Depression was more frequent amongst middle level graduates (3.2% at EE; 5.1% at HE; and 2.6% at UE). Income was significantly negatively associated with CVD (r = -0.130, p = 0.005), stress (r = -0.103, p = 0.028) and drug addiction (r = -0.117, p = 0.012), and significantly positively associated with the 'no problems' statement (r = 0.201, p = 0.000) which was reported by almost two fifths of the population. Worth noting is stress which, demonstrating no socioeconomic discrimination, was reported by high percentages of the population (17.2% of the sample). CONCLUSIONS Although with some limitations, this study has provided initial evidence for the existence of socioeconomically determined health inequalities, which may have potentially important implications for understanding the deeper aetiology of common NCDs and for informing public policies. More research in this area is required to reveal the magnitude of NCDS-socioeconomic relation.