4.6 Article

Regional differences in the impact of diabetes on population health in the USA

Journal

JOURNAL OF EPIDEMIOLOGY AND COMMUNITY HEALTH
Volume 75, Issue 1, Pages 56-61

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/jech-2020-214267

Keywords

Diabetes; quality of life; geography; epidemiology of chronic diseases; health expectancy

Funding

  1. Research Education Core of the Claude D. Pepper Older Americans Independence Center at Yale School of Medicine [P30AG021342]
  2. NIH/NIA [R01AG040199]

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The study found that diabetes has the greatest impact on life expectancy for older adults, especially those living in the Southern United States. Individuals born in the South with diabetes are more likely to develop chronic conditions or disabilities and spend more time with these issues compared to other regions.
Background To evaluate regional disparities in the influence of diabetes on population health, we examine life expectancies at age 50 between population with diabetes and healthy population and life quality among the population with diabetes among native-born Americans by birth region and current residence. Methods Using data on a cohort of 17 686 native-born individuals from the Health and Retirement Survey (1998-2014), we applied a Bayesian multistate life table method to estimate life expectancies at age 50 between population with diabetes and healthy population by each birth/current region combination. We further estimate the proportion of life remaining without either chronic conditions or disabilities as a quality of life measure and the probabilities that one region is worse than the other in terms of different health outcomes. Results At age 50, persons with diabetes (PWD) were expected to live on average 5.8-10.8 years less than their healthy equivalents across regions. Diabetes had the greatest influence on life expectancy (LE) for older adults who lived in the South at the time of interviews. PWD born in the South were more likely to have developed chronic conditions or disabilities and spent greater proportions of life with these two issues compared to other regions. Conclusion Diabetes is a significant threat to LE and healthy LE in the USA, particularly for people born or living in the South.

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