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Socioeconomic status and type 2 diabetes complications among young adult patients in Japan

Author

Listed:
  • Mitsuhiko Funakoshi
  • Yasushi Azami
  • Hisashi Matsumoto
  • Akemi Ikota
  • Koichi Ito
  • Hisashi Okimoto
  • Nobuaki Shimizu
  • Fumihiro Tsujimura
  • Hiroshi Fukuda
  • Chozi Miyagi
  • Sayaka Osawa
  • Ryo Osawa
  • Jiro Miura

Abstract

Objective: To assess the relationship between socioeconomic status (SES) and complications of type 2 diabetes among young adults in Japan. Design: A cross-sectional study. Setting: Outpatient wards of 96 member hospitals and clinics of the Japan Federation of Democratic Medical Institutions. Participants: A total of 782 outpatients with type 2 diabetes (525 males, 257 females), aged 20–40 years as of March 31, 2012. After excluding 110 participants whose retinopathy diagnosis was in question, 672 participants were analyzed. Measurements: We examined the relations between SES (educational level, income, type of public healthcare insurance, and employment status) and diabetes complications (retinopathy and nephropathy) using a multivariate logistic regression analysis. Results: The prevalence of type 2 diabetic retinopathy was 23.2%, while that of nephropathy was 8.9%. The odds of having retinopathy were higher among junior high school graduates (OR 1.91, 95% CI 1.09–3.34), patients receiving public assistance (OR 2.19, 95% CI 1.20–3.95), and patients with irregular (OR 1.72, 95% CI 1.03–2.86) or no employment (OR 2.23, 95% CI 1.36–3.68), compared to those with a higher SES, even after covariate adjustment (e.g., age, gender, body mass index). Similarly, the odds of having nephropathy were higher among patients with middle (OR 3.61, 95% CI 1.69–8.27) or low income levels (OR 2.53, 95% CI 1.11–6.07), even after covariate adjustment. Conclusions: Low SES was associated with a greater likelihood of type 2 diabetes complications in young adults. These findings suggest the necessity of health policies that mitigate socioeconomic disparity and thereby reduce the prevalence of diabetic complications.

Suggested Citation

  • Mitsuhiko Funakoshi & Yasushi Azami & Hisashi Matsumoto & Akemi Ikota & Koichi Ito & Hisashi Okimoto & Nobuaki Shimizu & Fumihiro Tsujimura & Hiroshi Fukuda & Chozi Miyagi & Sayaka Osawa & Ryo Osawa &, 2017. "Socioeconomic status and type 2 diabetes complications among young adult patients in Japan," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-14, April.
    • Handle: RePEc:plo:pone00:0176087
    DOI: 10.1371/journal.pone.0176087
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    References listed on IDEAS

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    1. Dinca-Panaitescu, Serban & Dinca-Panaitescu, Mihaela & Bryant, Toba & Daiski, Isolde & Pilkington, Beryl & Raphael, Dennis, 2011. "Diabetes prevalence and income: Results of the Canadian Community Health Survey," Health Policy, Elsevier, vol. 99(2), pages 116-123, February.
    2. Mackenbach, J.P. & Looman, C.W.N. & Van Der Meer, J.B.W., 1996. "Differences in the misreporting of chronic conditions, by level of education: The effect on inequalities in prevalence rates," American Journal of Public Health, American Public Health Association, vol. 86(5), pages 706-711.
    3. Nishi, Nobuo & Makino, Kae & Fukuda, Hideki & Tatara, Kozo, 2004. "Effects of socioeconomic indicators on coronary risk factors, self-rated health and psychological well-being among urban Japanese civil servants," Social Science & Medicine, Elsevier, vol. 58(6), pages 1159-1170, March.
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    Cited by:

    1. Young-Hoon Lee, 2018. "Socioeconomic differences among community-dwelling diabetic adults screened for diabetic retinopathy and nephropathy: The 2015 Korean Community Health Survey," PLOS ONE, Public Library of Science, vol. 13(1), pages 1-12, January.
    2. Laudicella, Mauro & Li Donni, Paolo & Prete, Vincenzo, 2024. "Healthcare utilisation by diabetic patients in Denmark: the role of primary care in reducing emergency visits," Health Policy, Elsevier, vol. 145(C).
    3. Emily L. Silverberg & Trevor W. Sterling & Tyler H. Williams & Grettel Castro & Pura Rodriguez de la Vega & Noël C. Barengo, 2021. "The Association between Social Determinants of Health and Self-Reported Diabetic Retinopathy: An Exploratory Analysis," IJERPH, MDPI, vol. 18(2), pages 1-12, January.

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