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Chen Y et al. 326-OR. Presented at: Scientific Sessions of the American Diabetes Association; 25-29 June 2021 (virtual meeting).
Disclosure:
Chen does not report any relevant financial information.
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Income inequalities from diabetes have risen in low-income communities in the United States since 2011, according to a speaker at the American Diabetes Association’s Scientific Sessions.
Data from the National Health Interview Survey showed that income-related inequalities in diabetes decreased from 2001 to 2011. However, inequalities began to worsen after 2011 and were more common in 2018 than in 2001.
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“We know that the overall prevalence of diabetes in the US has increased over the past two decades.” Yu Chen, PhD, from the Department of Diabetes Translation at the CDC, said during a presentation. “Diabetes prevalence follows a socio-economic gradient and the burden falls disproportionately on the low-income population. Although previous studies have looked at income and risk factors for the prevalence of diabetes in the United States, there have been no studies looking at recent changes in income inequalities in diabetes and the contributions to these changes over time. “
Chen and colleagues analyzed data from the National Health Interview Survey, which was conducted from 2001 to 2018 in adults aged 18 years and over. The researchers used the concentration index to measure income-related inequality in diabetes. The concentration index values ranged from -1 to 1, with a -1 indicating that diabetes is concentrated in lower income adults, a 0 indicating balanced income distribution, and a 1 indicating diabetes is concentrated in higher income adults. Data on age, gender, race, income level, BMI, smoking status and physical activity were collected for all participants.
All concentration index values were negative throughout the study period, suggesting that diabetes was concentrated in lower-income adults. The degree of diabetes inequality decreased from a confidence index of 0.16 in 2001 to 0.12 in 2011 (P = .013). Diabetes inequalities rose to a confidence index of 0.18 (P = 0.004) in 2018. Broken down by gender, diabetes was more concentrated in low-income groups in women than in men. In terms of age, adults aged 45 to 64 years had higher levels of income-related diabetes inequality compared to people aged 18 to 44 years and 65 years or older.
In an analysis of the covariates influencing inequalities in diabetes, income-poverty ratio, obesity, physical activity, and race were the four largest contributors to income-related inequalities in diabetes in 2001.
From 2001 to 2011, age and the poverty-to-income ratio were the main contributors to changing diabetes-related inequalities. The results were similar from 2011 to 2018, with obesity also contributing to more income-related inequalities.
“[Obesity’s] This contribution was mainly because obese adults were more concentrated in the low-income groups in 2018 than in 2011, ”said Chen.
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