Speaker 1: Dalia Tsimpida - Socioeconomic inequalities and hearing health in England
Main topics include:
a) The construction of a Conceptual Model for the emerging research area of hearing health inequalities, which depicts the modifiable factors for hearing loss during the life-course and the mechanisms between socioeconomic inequalities and hearing health.
The Hearing Health Inequalities Model (HHI Model) could be used as a tool for prevention, identification and management of hearing health inequalities and for policy formulation aimed at hearing loss risk reduction.
b) The findings of the first study in hearing loss research that examines the effects of four different indicators of socioeconomic position (education, occupation, income, wealth) to the objectively measured hearing loss in older adults, and explores how major lifestyle factors (such as smoking, high BMI, insufficient physical activity and excessive alcohol consumption) account for the variance in hearing loss, using data from the English Longitudinal Study of Ageing (ELSA).
c) Preliminary findings from a study regarding the diagnosis of hearing loss in primary care, which offers an explanation why those of a lower socioeconomic position use specialist health services less frequently, in spite of the financial support of the treatment and hearing aid provision through the NHS in the UK.
Speaker 2: Dr Rathi Ravindrarajah - NHS Diabetes Prevention Programme
Background
Individuals with higher than normal glucose levels are termed as having Non diabetic Hyperglycaemia (NDH) or prediabetes. It is known that they are at increased risk of developing type-2 diabetes (T2DM).
Methods Electronic health records identified 14,272 participants with NDH, from 2000 to 2015. Baseline characteristics and conversion trends from NDH to T2DM were explored. Cox proportional-hazards models evaluated predictors of conversion.
Findings Crude conversion was 4% within 6 months of NDH diagnosis, 7% annually, 13% within 2 years, 17% within 3 years and 23% within 5 years. However, 1-year conversion fell from 8% in 2000 to 4% in 2014. Individuals aged 45-54 were at the highest risk of developing T2DM (HR= 1.20; 95% CI: 1.15, 1.25 – compared to those aged 18-44), and the risk reduced with older age. A BMI above 30 was strongly associated with conversion (HR=2.02; 95% CI: 1.92, 2.13 – compared to those with a normal BMI). Depression (HR=1.10; 95% CI: 1.07, 1.13), smoking (HR=1.07; 95% CI: 1.03, 1.11 – compared to non-smokers) or residing in the most deprived areas (HR=1.17; 95% CI: 1.11, 1.24 – compared to residents of the most affluent areas) was modestly associated with conversion.
Interpretation
Although the rate of conversion from NDH to T2DM fell between 2010 and 2015, this is likely due to changes over time in the cut-off points for defining NDH, and more people of lower diabetes risk being diagnosed with NDH over time. People aged 45-54, smokers, depressed, with high BMI, and more deprived are at increased risk of conversion to T2DM.
