Less Education Linked to Higher Mortality in Diabetes

In relative terms, this disparity is weaker than that among adults without diabetes
By Jeff Muise
HealthDay Reporter

MONDAY, June 14 (HealthDay News) -- The mortality risk among adults with diabetes differs greatly by educational level, and although the relative disparities in this population are not as strong as those in adults without diabetes, their absolute impact is greater, according to a study in the June issue of Diabetes Care.

Rosemary Dray-Spira, M.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, and colleagues analyzed data on 85,867 individuals (aged 35 to 84 years), including 5,007 with diabetes, from the National Health Interview Survey (1986 to 1996). The researchers followed the cohort through 2002, then compared educational disparities, based on level of education attained, for all-cause mortality, cardiovascular disease (CVD) mortality, and non-CVD mortality for those with diabetes versus those without diabetes.

The researchers found that diabetes patients with the lowest educational attainment had a 28 percent higher all-cause mortality risk than those with the highest educational attainment. This relationship reflected substantial disparities in CVD mortality in particular. The relative disparities in this population were substantial yet weaker than disparities in mortality among adults without diabetes. In absolute terms, adults with diabetes with the lowest educational attainment suffered 503 excess deaths per 10,000 person-years of follow-up, compared to those with the highest educational achievement. These absolute disparities were stronger than the disparities among adults without diabetes.

"Considering the major burden of diabetes in the United States, especially among the most deprived categories of the population, this suggests that reducing social health inequalities among people with diabetes is likely to have a major public health impact. Future research should determine pathways underlying these educational disparities with an eye toward developing strategies to eliminate them," the authors conclude.

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