Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)

Introduction The geographical distribution of hypoglycemic events requiring emergency assistance was explored in Andalusia (Spain), and potentially associated societal factors were determined.Research design and methods This was a database analysis of hypoglycemia requiring prehospital emergency ass...

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Main Authors: Fernando Gomez-Peralta, Cristina Abreu, Manuel Benito, Rafael J Barranco
Format: Article
Language:English
Published: BMJ Publishing Group 2021-03-01
Series:BMJ Open Diabetes Research & Care
Online Access:https://drc.bmj.com/content/9/1/e001731.full
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author Fernando Gomez-Peralta
Cristina Abreu
Manuel Benito
Rafael J Barranco
author_facet Fernando Gomez-Peralta
Cristina Abreu
Manuel Benito
Rafael J Barranco
author_sort Fernando Gomez-Peralta
collection DOAJ
description Introduction The geographical distribution of hypoglycemic events requiring emergency assistance was explored in Andalusia (Spain), and potentially associated societal factors were determined.Research design and methods This was a database analysis of hypoglycemia requiring prehospital emergency assistance from the Public Company for Health Emergencies (Empresa Pública de Emergencias Sanitarias (EPES)) in Andalusia during 2012, which served 8 393 159 people. Databases of the National Statistics Institute, Basic Spatial Data of Andalusia and System of Multiterritorial Information of Andalusia were used to retrieve spatial data and population characteristics. Geographic Information System software (QGIS and GeoDA) was used for analysis and linkage across databases. Spatial analyses of geographical location influence in hypoglycemic events were assessed using Moran’s I statistics, and linear regressions were used to determine their association with population characteristics.Results The EPES attended 1 137 738 calls requesting medical assistance, with a mean hypoglycemia incidence of 95.0±61.6 cases per 100 000 inhabitants. There were significant differences in hypoglycemia incidence between basic healthcare zones attributable to their geographical location in the overall population (Moran’s I index 0.122, z-score 7.870, p=0.001), women (Moran’s I index 0.088, z-score 6.285, p=0.001), men (Moran’s I index 0.076, z-score 4.914, p=0.001) and aged >64 years (Moran’s I index 0.147, z-score 9.753, p=0.001). Hypoglycemia incidence was higher within unemployed individuals (β=0.003, p=0.001) and unemployed women (β=0.005, p=0.001), while lower within individuals aged <16 years (β=−0.004, p=0.040), higher academic level (secondary studies) (β=−0.003, p=0.004) and women with secondary studies (β=−0.005, p<0.001). In subjects aged >64 years, lower rate of hypoglycemia was associated with more single-person homes (β=−0.008, p=0.022) and sports facilities (β=−0.342, p=0.012).Conclusions This analysis supports the geographical distribution of hypoglycemia in the overall population, both genders and subjects aged >64 years, which was affected by societal factors such as unemployment, literacy/education, housing and sports facilities. These data can be useful to design specific prevention programs.
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spelling doaj-art-0f9db21acb7b4bca92507549e724aab72025-08-20T01:58:45ZengBMJ Publishing GroupBMJ Open Diabetes Research & Care2052-48972021-03-019110.1136/bmjdrc-2020-001731Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)Fernando Gomez-Peralta0Cristina Abreu1Manuel Benito2Rafael J Barranco3Endocrinology and Nutrition Unit, Segovia Hospital Complex, Segovia, Castilla y León, SpainEndocrinology and Nutrition Unit, Hospital General de Segovia, Segovia, SpainDepartment of Urbanism, School of Architecture, Polytechnic University of Madrid, Madrid, SpainDepartment of Health Sciences, University of Jaén, Jaen, SpainIntroduction The geographical distribution of hypoglycemic events requiring emergency assistance was explored in Andalusia (Spain), and potentially associated societal factors were determined.Research design and methods This was a database analysis of hypoglycemia requiring prehospital emergency assistance from the Public Company for Health Emergencies (Empresa Pública de Emergencias Sanitarias (EPES)) in Andalusia during 2012, which served 8 393 159 people. Databases of the National Statistics Institute, Basic Spatial Data of Andalusia and System of Multiterritorial Information of Andalusia were used to retrieve spatial data and population characteristics. Geographic Information System software (QGIS and GeoDA) was used for analysis and linkage across databases. Spatial analyses of geographical location influence in hypoglycemic events were assessed using Moran’s I statistics, and linear regressions were used to determine their association with population characteristics.Results The EPES attended 1 137 738 calls requesting medical assistance, with a mean hypoglycemia incidence of 95.0±61.6 cases per 100 000 inhabitants. There were significant differences in hypoglycemia incidence between basic healthcare zones attributable to their geographical location in the overall population (Moran’s I index 0.122, z-score 7.870, p=0.001), women (Moran’s I index 0.088, z-score 6.285, p=0.001), men (Moran’s I index 0.076, z-score 4.914, p=0.001) and aged >64 years (Moran’s I index 0.147, z-score 9.753, p=0.001). Hypoglycemia incidence was higher within unemployed individuals (β=0.003, p=0.001) and unemployed women (β=0.005, p=0.001), while lower within individuals aged <16 years (β=−0.004, p=0.040), higher academic level (secondary studies) (β=−0.003, p=0.004) and women with secondary studies (β=−0.005, p<0.001). In subjects aged >64 years, lower rate of hypoglycemia was associated with more single-person homes (β=−0.008, p=0.022) and sports facilities (β=−0.342, p=0.012).Conclusions This analysis supports the geographical distribution of hypoglycemia in the overall population, both genders and subjects aged >64 years, which was affected by societal factors such as unemployment, literacy/education, housing and sports facilities. These data can be useful to design specific prevention programs.https://drc.bmj.com/content/9/1/e001731.full
spellingShingle Fernando Gomez-Peralta
Cristina Abreu
Manuel Benito
Rafael J Barranco
Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)
BMJ Open Diabetes Research & Care
title Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)
title_full Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)
title_fullStr Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)
title_full_unstemmed Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)
title_short Geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in Andalusia (Spain)
title_sort geographical clustering and socioeconomic factors associated with hypoglycemic events requiring emergency assistance in andalusia spain
url https://drc.bmj.com/content/9/1/e001731.full
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AT manuelbenito geographicalclusteringandsocioeconomicfactorsassociatedwithhypoglycemiceventsrequiringemergencyassistanceinandalusiaspain
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