BACKGROUND: Low socioeconomic status (SES) is associated with adverse cardiovascular risk factor patterns and poorer outcomes for people with diabetes. METHODS: A cross-sectional study was performed using data for 35,925 people with diagnosed diabetes in Scotland and an area-based measure of SES using linked hospital and population-based diabetes register records. Comparisons by quintile of SES were made before (with p values presented for trend across quintiles given below) and after adjusting for other factors using multivariable logistic regression. RESULTS: People in the most deprived quintile were more likely than people in the most affluent quintile to have hospital records for diabetic kidney disease (2.4% vs 2.0%, p=0.049), diabetic ketoacidosis (3.5% vs 3.0%, p=0.11), hypoglycaemia (1.8% vs 1.4%, p=0.008), ischaemic heart disease (22% vs 17%, p<0.0001), stroke (6.8% vs 5.1%, p<0.0001) and peripheral arterial disease (4.1% vs 2.1%, p<0.0001). An independent effect of SES persisted for cardiovascular disease outcomes after adjusting for age and sex. There were minimal differences in disease management measures by SES. CONCLUSION: Managing current risk factors equitably is unlikely to remove socioeconomic inequalities in diabetes-related outcomes. Measures of SES may be valuable in risk scores and in making valid comparisons of the quality of diabetes care.
BACKGROUND: Low socioeconomic status (SES) is associated with adverse cardiovascular risk factor patterns and poorer outcomes for people with diabetes. METHODS: A cross-sectional study was performed using data for 35,925 people with diagnosed diabetes in Scotland and an area-based measure of SES using linked hospital and population-based diabetes register records. Comparisons by quintile of SES were made before (with p values presented for trend across quintiles given below) and after adjusting for other factors using multivariable logistic regression. RESULTS:People in the most deprived quintile were more likely than people in the most affluent quintile to have hospital records for diabetic kidney disease (2.4% vs 2.0%, p=0.049), diabetic ketoacidosis (3.5% vs 3.0%, p=0.11), hypoglycaemia (1.8% vs 1.4%, p=0.008), ischaemic heart disease (22% vs 17%, p<0.0001), stroke (6.8% vs 5.1%, p<0.0001) and peripheral arterial disease (4.1% vs 2.1%, p<0.0001). An independent effect of SES persisted for cardiovascular disease outcomes after adjusting for age and sex. There were minimal differences in disease management measures by SES. CONCLUSION: Managing current risk factors equitably is unlikely to remove socioeconomic inequalities in diabetes-related outcomes. Measures of SES may be valuable in risk scores and in making valid comparisons of the quality of diabetes care.
Authors: Seth A Berkowitz; Andrew J Karter; Courtney R Lyles; Jennifer Y Liu; Dean Schillinger; Nancy E Adler; Howard H Moffet; Urmimala Sarkar Journal: J Health Care Poor Underserved Date: 2014-05
Authors: L Govan; E Maietti; B Torsney; O Wu; A Briggs; H M Colhoun; C M Fischbacher; G P Leese; J A McKnight; A D Morris; N Sattar; S H Wild; R S Lindsay Journal: Diabetologia Date: 2012-06-26 Impact factor: 10.122
Authors: Seth A Berkowitz; Katherine Aragon; Jonas Hines; Hilary Seligman; Sei Lee; Urmimala Sarkar Journal: Health Serv Res Date: 2013-02-28 Impact factor: 3.402
Authors: Muhammad A Sajjad; Kara L Holloway-Kew; Mohammadreza Mohebbi; Mark A Kotowicz; Lelia L F de Abreu; Patricia M Livingston; Mustafa Khasraw; Sharon Hakkennes; Trisha L Dunning; Susan Brumby; Richard S Page; Alasdair G Sutherland; Svetha Venkatesh; Lana J Williams; Sharon L Brennan-Olsen; Julie A Pasco Journal: BMJ Open Date: 2019-05-22 Impact factor: 2.692