Introduction The chronic course of the disease and regular need for healthcare suggests that people with diabetes mellitus might be more affected by the socioeconomic inequalities in health. We assessed whether socioeconomic differences exist in mortality of diabetes patients in Latvia.
Methods The study population consisted of 4179 diabetes patients (1339 men and 2840 women) participating in the Latvian diabetes survey in 2000. All deaths (n=1771) during a subsequent ten-year period and causes of death were identified through the Causes of Death Data Base. The Cox model was used to test associations (HR (95% CI) presented) between education, income and residence (rural/urban) and mortality, adjusted for age, duration of diabetes, glycaemia, and blood pressure.
Results The primary education, compared to the higher education, was associated with an increase in all-cause, cardiovascular mortality and death from diabetes in both men (1.45 (1.16–1.82); 1.45 (1.07–1.95); 2.33 (1.23–4.40), respectively) and women (1.91 (1.53–2.38); 1.72 (1.31–2.25); 2.37 (1.25–4.48), respectively). The lowest income tertile, compared to the highest, was associated with higher all-cause mortality in both men (1.42 (1.14–1.77)) and women (1.37 (1.14–1.65)), as well as with higher cardiovascular mortality in men (1.44 (1.06–1.94)). Rural residence was associated with lower cardiovascular mortality in men (0.70 (0.50–0.98)). The strength of associations did not change substantially when smoking, alcohol consumption, or parameters of diabetes care were included in the model.
Conclusion Overall, diabetes patients with poorer education and lower income experienced higher mortality. These inequalities were not explained by behavioural factors or diabetes care.
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