Original Research

Urban–suburban differences in the demographics and clinical profiles of type 2 diabetic patients attending primary healthcare centres in Malta

AUTHORS

Tania Cardona1 MD (Melit), Specialist Trainee *

Neville Calleja2 FRSPH, DLSHTM, Public Health Consultant

Glorianne Pullicino3 MRCGP (INT), MMCFD, Assistant Lecturer

AFFILIATIONS

1, 3 Department of Family Medicine, University of Malta, Tal-Qroqq, Msida, MSD 2080, Malta

2 Directorate for Information and Research, 95, Telgha ta’ Gwardamangia, Tal-Pieta, PTA 1313, Malta

ACCEPTED: 15 September 2020


early abstract:

Introduction: Social factors might bring about health inequities. Vulnerable population groups including those suffering from non-communicable diseases such as type 2 diabetes and depression might be more prone to suffering the effects of such inequities. This study aimed to identify the type 2 diabetic patients with depression in a primary care setting with the objective of describing health inequities among urban and suburban dwellers.
Methods: A quantitative, retrospective and descriptive study was carried out among diabetic patients attending public primary health care centres in different regions of the country. Participants completed a self-administered questionnaire to study patient and disease characteristics. Convenience sampling was used.
Results: The logistic regression model predicting the likelihood of different factors occurring with suburban diabetic patients as opposed to those residing in urban areas contained five independent variables (severity of depression, monthly income, blood capillary glucose readings, weight and nationality). The full model containing all predictors was statistically significant, χ2 (chi-squared), (5, N = 400), p < 0.001, indicating that the model was able to distinguish between urban and suburban areas. The model as a whole explained between 10% (Cox and Snell R square) and 20% (Nagelkerke R squared) of the variance in urban and suburban areas, and correctly classified 73.8% of cases. All five of the independent variables made a unique, statistically significant contribution to the model. Elevated blood glucose and obesity tended to be more prevalent in suburban respondents as opposed to urban participants. Conversely, diabetic participants living in urban areas were more likely to be depressed and non-Maltese with a higher income.
Conclusion: Despite the small size of the Maltese islands and the expected social homogeneity, health inequities still exist, highlighting the importance of social factors on the epidemiology of disease. This study provides information for health care professionals and policymakers to mitigate the effects of social inequities on vulnerable population groups.