Visual Abstract

Overall prevalence of diabetes has increased since the year 2000 in the US, disproportionately affecting low-income populations. Recent changes in income-related inequalities (IRI) in diabetes prevalence are unknown. We estimated IRI in diagnosed diabetes in 2001−2018 among US adults aged ≥ 18 years using data from the National Health Interview Survey. We assessed IRI using the Concentration Index (CI). The CI ranges from -1 to 1, with negative values indicating diabetes was concentrated among low-income groups. Trends were assessed using Joinpoint regression. During 2001−2018, all CIs were negative (Figure). The degree of inequality (absolute value of CIs) decreased from 0.16 in 2001 to 0.12 in 2011 (annual percentage change [APC] -2.5, p=0.013), and then increased to 0.18 in 2018 (APC 4.7, p=0.004). The degree of IRI in diabetes differed by sex and age group. Diabetes was more concentrated in low-income groups among females than males. For females, the degree of inequality decreased during 2001−2012 (APC -2.5, p=0.024) and increased after 2012 (APC 4.7, p=0.097); for males, the trend of the inequality was not statistically significant. Among age groups, adults aged 45-64 years had the highest level of IRI in diabetes. Also, the degree of inequality increased in each age group during 2001−2018 (all p<0.05). Future studies may investigate the factors accounting for these inequalities.

Disclosure

Y. Chen: None. X. Zhou: None. K. M. Bullard: None. P. Zhang: None. G. Imperatore: None. D. B. Rolka: None.

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