The relationship between socioeconomic status/income and prevalence of diabetes and associated conditions: A cross-sectional population-based study in Saskatchewan, Canada

IntroductionThe role that socioeconomic status/income play in accounting for the increased prevalence of type 2 diabetes has not been sufficiently studied in Canada. The primary purpose of the present study was to determine the unadjusted and adjusted effect of income on type 2 diabetes. The secondary purpose was to determine the adjusted effect of income on diabetes associated conditions such as high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity.MethodsThis is a cross-sectional, population-based study. Data was analyzed from four cycles of the Canadian Community Health Survey (CCHS). It was conducted by Statistics Canada and covered the time period of 2000–2008 in the province of Saskatchewan, Canada. In this study, four separate and distinct multivariate models were built to determine the independent effect of income on type 2 diabetes and the associated conditions of high blood pressure, being overweight or obese, and physical inactivity.ResultsThe total sample size was comprised of 27,090 residents from Saskatchewan. After statistically controlling for age, only six covariates were independently associated with type 2 diabetes prevalence including: having high blood pressure (OR = 3.26), visible minority cultural status (OR = 2.17), being overweight or obese (OR = 1.97), being of male gender (OR = 1.76), having a household income of $29,999 per year (OR = 1.63) and being physically inactive (OR = 1.15).ConclusionsIn this study, household income was strongly and independently associated with type 2 diabetes prevalence, its associated conditions of high blood pressure and being overweight or obese, and its main behavioral factor of physical inactivity. We suggest that income is an important but frequently overlooked factor for type 2 diabetes and worthy of further investigation, appropriate public debate and timely policy intervention.

[1]  V. Vaccarino,et al.  Socioeconomic status and type 2 diabetes in African American and non-Hispanic white women and men: evidence from the Third National Health and Nutrition Examination Survey. , 2001, American journal of public health.

[2]  M. Lemstra,et al.  Health Disparity by Neighbourhood Income , 2006, Canadian journal of public health = Revue canadienne de sante publique.

[3]  P. Allebeck,et al.  Type 2 diabetes incidence and socio-economic position: a systematic review and meta-analysis. , 2011, International journal of epidemiology.

[4]  J. Mackenbach,et al.  High health care utilization and costs associated with lower socio-economic status: results from a linked dataset. , 2009, Canadian journal of public health = Revue canadienne de sante publique.

[5]  C. Muntaner,et al.  Socioeconomic Stratification and Mental Disorder , 1999 .

[6]  Yves Béland,et al.  Canadian community health survey--methodological overview. , 2002, Health reports.

[7]  Jeffrey A. Johnson,et al.  An algorithm to differentiate diabetic respondents in the Canadian Community Health Survey. , 2008, Health reports.

[8]  J. Mackenbach,et al.  Socioeconomic inequalities in diabetes mellitus across Europe at the beginning of the 21st century , 2008, Diabetologia.

[9]  M. Sayeed,et al.  Effect of Socioeconomic Risk Factors on the Difference in Prevalence of Diabetes Between Rural and Urban Populations in Bangladesh , 1997, Diabetes Care.

[10]  Tara-Leigh F. McHugh,et al.  Barriers to Optimizing Investments in the Built Environment to Reduce Youth Obesity: Policy-maker Perspectives , 2010, Canadian journal of public health = Revue canadienne de sante publique.

[11]  David W. Hosmer,et al.  Applied Logistic Regression , 1991 .

[12]  Tezeta F. Mitiku,et al.  Trends in risk factors for cardiovascular disease in Canada: temporal, socio-demographic and geographic factors , 2009, Canadian Medical Association Journal.

[13]  J. Mackenbach,et al.  High Health Care Utilization and Costs Associated with Lower Socio-economic Status: Results from a Linked Dataset , 2009 .

[14]  D. Istance.  Organization for Economic Co-operation and Development , 1966, Nature.

[15]  Tim Nolan,et al.  International Diabetes Federation. , 2013, Diabetes research and clinical practice.

[16]  P. Austin,et al.  Income-related differences in mortality among people with diabetes mellitus , 2010, Canadian Medical Association Journal.

[17]  Godfrey Fowler,et al.  THE STRATEGY OF PREVENTIVE MEDICINE , 1992 .

[18]  D. Raphael,et al.  Diabetes prevalence and income: Results of the Canadian Community Health Survey. , 2011, Health policy.