Article ; Online: Sustained Low Income, Income Changes, and Risk of All-Cause Mortality in Individuals With Type 2 Diabetes: A Nationwide Population-Based Cohort Study.
2022 Volume 46, Issue 1, Page(s) 92–100
Abstract: Objective: There is limited evidence on the association of sustained low-income status, income changes, and all-cause mortality risk in individuals with type 2 diabetes (T2D).: Research design and methods: Using the Korean Health Insurance Service ... ...
| Abstract | Objective: There is limited evidence on the association of sustained low-income status, income changes, and all-cause mortality risk in individuals with type 2 diabetes (T2D). Research design and methods: Using the Korean Health Insurance Service database, we studied 1,923,854 adults with T2D (aged ≥30 years) without cardiovascular disease and cancer, who were enrolled from 2009 through 2012 and followed to the end of 2020 (median 10.8 years of follow-up). We defined income levels based on the amount of health insurance premiums and categorized them into quartiles, the first being the low-income group, and assessed the income status annually in the preceding 5 years. Cox proportional hazards models were used to quantify the association of low-income status and income changes with mortality, with adjustment for sociodemographic factors, comorbidities, and diabetes duration and treatment. Results: Participants who consecutively had low income showed a higher risk of mortality (hazard ratio [HR] 1.19; 95% CI 1.16-1.22), compared with those who had never been in the low-income group. This association was much stronger for consecutive recipients of Medical Aid, reflecting very-low-income status (HR 2.26; 95% CI 2.16-2.36), compared with those who had never been Medical Aid beneficiaries. Sustained low- and very-low-income status was associated with increased risk of mortality, specifically for younger adults (aged <40 years) and males. Those who experienced declines in income between the first (preceding 5 years) and the last (baseline) time points had an increased risk of mortality, regardless of baseline income status. Conclusions: Among Korean adults with T2D, sustained low-income status and declines in income were associated with increased risk of mortality. |
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| MeSH term(s) | Adult ; Male ; Humans ; Diabetes Mellitus, Type 2/epidemiology ; Cohort Studies ; Income ; Socioeconomic Factors ; Poverty ; Cardiovascular Diseases ; Risk Factors |
| Language | English |
| Publishing date | 2022-11-08 |
| Publishing country | United States |
| Document type | Journal Article ; Research Support, Non-U.S. Gov't |
| ZDB-ID | 441231-x |
| ISSN | 1935-5548 ; 0149-5992 |
| ISSN (online) | 1935-5548 |
| ISSN | 0149-5992 |
| DOI | 10.2337/dc21-2305 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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