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Understanding the determinants of health for people with type 2 diabetes

Author

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  • Maddigan, S.L.
  • Feeny, D.H.
  • Majumdar, S.R.
  • Farris, K.B.
  • Johnson, J.A.

Abstract

Objective. We assessed which of a broad range of determinants of health are most strongly associated with health-related quality of life (HRQL) among people with type 2 diabetes. Methods. Our analysis included respondents from the Canadian Community Health Survey Cycle 1.1 (2000-2001) who were aged 18 years and older and who were identified as having type 2 diabetes. We used regression analyses to assess the associations between the Health Utilities Index Mark 3 and determinants of health. Results. Comorbidities had the largest impact on HRQL, with stroke (-0.11; 95% confidence interval [CI] = -0.17, -0.06) and depression (-0.11; 95% CI = -0.15, -0.06) being associated with the largest deficits. Large differences in HRQL were observed for 2 markers of socioeconomic status: social assistance (-0.07; 95% CI = -0.12, -0.03) and food insecurity (-0.07; 95% CI = -0.10, -0.04). Stress, physical activity, and sense of belonging also were important determinants. Overall, 36% of the variance in the Health Utilities Index Mark 3 was explained. Conclusion. Social and environmental factors are important, but comorbidities have the largest impact on HRQL among people with type 2 diabetes.

Suggested Citation

  • Maddigan, S.L. & Feeny, D.H. & Majumdar, S.R. & Farris, K.B. & Johnson, J.A., 2006. "Understanding the determinants of health for people with type 2 diabetes," American Journal of Public Health, American Public Health Association, vol. 96(9), pages 1649-1655.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2005.067728_1
    DOI: 10.2105/AJPH.2005.067728
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    Cited by:

    1. Heng Yaw Yong & Zalilah Mohd Shariff & Barakatun Nisak Mohd Yusof & Zulida Rejali & Yvonne Yee Siang Tee & Jacques Bindels & Eline M. van der Beek, 2021. "Higher Parity, Pre-Pregnancy BMI and Rate of Gestational Weight Gain Are Associated with Gestational Diabetes Mellitus in Food Insecure Women," IJERPH, MDPI, vol. 18(5), pages 1-11, March.
    2. Asakawa, Keiko & Feeny, David & Senthilselvan, Ambikaipakan & Johnson, Jeffrey A. & Rolfson, Darryl, 2009. "Do the determinants of health differ between people living in the community and in institutions?," Social Science & Medicine, Elsevier, vol. 69(3), pages 345-353, August.
    3. Odelia Koh & Jeannette Lee & Maudrene L S Tan & E-Shyong Tai & Ce Jin Foo & Kok Joon Chong & Su-Yen Goh & Yong Mong Bee & Julian Thumboo & Yin-Bun Cheung & Avjeet Singh & Hwee-Lin Wee, 2014. "Establishing the Thematic Framework for a Diabetes-Specific Health-Related Quality of Life Item Bank for Use in an English-Speaking Asian Population," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-12, December.
    4. Tia Palermo & Rahul Rawat & Sheri D Weiser & Suneetha Kadiyala, 2013. "Food Access and Diet Quality Are Associated with Quality of Life Outcomes among HIV-Infected Individuals in Uganda," PLOS ONE, Public Library of Science, vol. 8(4), pages 1-11, April.
    5. Sandra Tunis, 2011. "Cost effectiveness of self-monitoring of blood glucose (SMBG) for patients with type 2 diabetes and not on insulin," Applied Health Economics and Health Policy, Springer, vol. 9(6), pages 351-365, November.

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