Socio-economic predictors of mortality among diabetic people.

BACKGROUND: The present study examines the role of six aspects of socio-economic status (income, occupational position, education, unemployment, living alone and type of residential area) in mortality among types 1 and 2 diabetic people in Finland. All-cause mortality and causes of deaths (for example, alcohol diseases) are assessed.
METHODS: People with diabetes aged 30-79 years in 2000-03 were identified from national registers. The data comprised 528 734 person-years and 18 841 deaths. Relative mortality risks were obtained from Poisson regression models.
RESULTS: Among type 1 diabetic men, mortality differences were largest for long-term unemployed (aged 30-64 years); RR 3.85 (3.00-4.94) compared with the employed, and for low (vs. high) income group; RR 1.96 (1.78-2.17). The findings were similar for type 2 men; RR 2.58 (2.16-3.09) for unemployment and 1.61 (1.53-1.69) for income. In type 1 diabetic women, largest differences were found according to unemployment; RR 3.32 (1.88-5.88) and education (lowest vs. highest education); RR 2.35 (1.84-3.00), but in type 2 diabetes, the strongest determinants were disposable income; RR 1.55 (1.44-1.66) and education; RR 1.50 (1.33-1.70). In most socio-economic determinants, relative differences were largest in deaths due to diabetes and alcohol diseases.
CONCLUSIONS: Five aspects of socio-economic position were related to mortality among diabetic people in Finland. No systematic mortality differences were, however, found for type of municipality of residence. These findings together with the role of deaths from alcohol diseases and diabetes in mortality trends, indicate that different aspects of social disadvantage are important predictors of mortality among diabetic people.