Social determinants of health and diabetes: Results from a cohort study in Iran

Introduction: The relationship between social factors and diabetes has mainly been studied in developed countries. Few studies investigated the relationship between social factors and diabetes in developing countries. This study aimed to identify the social factors affecting diabetes in the population covered by the Hoveyzeh Cohort Study (HCS) in Iran. Methods: This was a cross-sectional analysis conducted on the participants of the HCS (recruited from May 2016 to August 2018), in Iran. The desired information included age, sex, marital status, education, body mass index (BMI), physical activity, Townsend deprivation index, and wealth index and their relation to diabetes. A logistic regression model was used to explore the data. Results: In all, the data from 10,009 adults aged from 35 to 70 years were analyzed. Of these, 2226 were diabetic and 7783 were nondiabetic. The results of multiple logistics indicated significant associations between age, physical activity, BMI, and diabetes status. In addition, the analysis showed that people who reside in most affluent areas (odds ratio [OR] = 1.39, 95% confidence interval [CI]: 1.21–1.60) and individuals who reside in affluent areas (OR = 1.25, 95% CI: 1.08–1.46] were more likely to experience a higher risk of diabetes compared to those who live in most deprived areas. Conclusion: The findings showed that people with older age, lower physical activity, higher BMI, and affluent background were more likely to develop diabetes. Future studies are needed to confirm such an observation. Perhaps social class might play different roles in low-, middle-, and high-income countries. Health promotion interventions to reduce diabetes should incorporate socioeconomic situations in their plans in a deprived area like Hoveyzeh, Iran.