Socioeconomic disparities in diabetes-concordant comorbidity: national health interview survey, 1997–2018

Abstract

ObjectiveAlthough social disparities in morbidity and mortality are well-documented, little is known how socioeconomic status (SES) shapes diabetes-concordant comorbidity (DCC). This study examines socioeconomic inequalities in DCC among adults with diabetes in the United States. Study designThe study incorporated a cross-sectional nationally representative household health survey. MethodsThis study used data from the National Health Interview Survey, 1997–2018. The analysis included 56,192 adults aged 30 or above with diabetes. Multinomial logistic regression was used to obtain relative risk ratios in gender-stratified models after adjusting for sociodemographic covariates. ResultsThe multivariable-adjusted analyses suggest that across all SES indicators and in both men and women, individuals with lower SES had greater odds of DCC than individuals with higher SES. The associations of SES indicators with DCC were larger in magnitude among women than in men. For example, compared to individuals with a college or higher degree, men with less than a high school degree were 2.06 times (95% confidence interval = 1.76–2.41) and women with less than a high school degree were 3.19 times (95% confidence interval = 2.67–3.82) more likely to have 3 or more DCCs. Similar associations were observed for other indicators of SES. ConclusionStudy findings suggest strong social status and gender-based patterns in DCC. Identifying population groups with poor social status may be useful for informing interventions aiming to improve healthcare services of diabetes-related complications.