Gender disparities in the association between socio-demographics and non-communicable disease risk factors among adults with disabilities in Shanghai, China

Author:

Zhang Youran12,Chen Gang12,Zhang Qi3,Lu Jun2,Yu Huijiong4

Affiliation:

1. Department of Health Law and Health Inspection, School of Public Health, Fudan University, Shanghai, China

2. China Research Center on Disability Issues at Fudan University, Shanghai, China

3. School of Community and Environmental Health, Old Dominion University, Norfolk, VA, United States of America

4. Department of Rehabilitation, Shanghai Disabled Persons’ Federation, Shanghai, China

Abstract

Background Non-communicable disease (NCD) risk factors can co-exist with disability and cause a greater burden on the health status of adults with disabilities. A lack of egalitarian social policies in China may result in gender disparities in the NCD risk factors of adults with disabilities. However, little is known about the gender disparities in the association between socio-demographics and NCD risk factors among adults with disabilities in China; consequently, we examined this association among adults with disabilities in Shanghai, China. Methods We used the health examination data of 44,896 adults with disabilities in Shanghai in 2014. Descriptive analyses and logistic regression models were conducted to estimate gender disparities in the association between socio-demographics, disability characteristics, and four selected NCD risk factors among adults with disabilities—including high blood pressure, high blood glucose, high blood lipids, and being overweight. We estimated marginal effects (MEs) on NCD risk factors between gender and other confounders. Results Women with disabilities were about 11.6 percentage points more likely to suffer from high blood lipids and less likely to develop the other three risk factors than men were. The association of age group, residence permit, education level, marital status, and disability type with health outcomes varied by gender among adults with disabilities. The difference in age effects between men and women was more pronounced in older age groups. Urban residence was associated with less risk of high blood pressure risk among women (ΔME =  − 0.035, p < 0.01), but no significant difference in other NCD risk factors. Education remained a major protective factor against high blood pressure, high blood glucose and being overweight among women with disabilities (MEs < 0, p < 0.05); however, this did not hold for men. The difference in marriage effects between men and women was observed in high blood lipids (ΔME =  − 0.048 for the married group and −0.054 for the divorced or widowed group) and overweight individuals (ΔME =  − 0.091 for the married group and −0.114 for the divorced or widowed group). Women with intellectual disabilities or mental disabilities reported worse health conditions than men did. Discussion Preventive strategies and interventions on NCD risk factors for adults with disabilities should take into account gender disparities in these socio-demographic effects. Rural women or poorly educated women with disabilities can be a vulnerable population that requires more health education and promotion strategies. Health education for caregivers of women with intellectual or mental disabilities may also play a vital role in preventing their NCD risk factors.

Funder

Shanghai Disabled Persons’ Federation (SHDPF)

111 Project

Publisher

PeerJ

Subject

General Agricultural and Biological Sciences,General Biochemistry, Genetics and Molecular Biology,General Medicine,General Neuroscience

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