Open AccessAssociations between economic hardship and markers of self‐management in adults with type 2 diabetes: results from Diabetes MILES – Australia
Author(s) -
O'Neil Adrienne,
Williams Emily D.,
Browne Jessica L.,
Horne Rob,
Pouwer Frans,
Speight Jane
Publication year - 2014
Publication title -
australian and new zealand journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.946
H-Index - 76
eISSN - 1753-6405
pISSN - 1326-0200
DOI - 10.1111/1753-6405.12153
Subject(s) - socioeconomic status , diabetes mellitus , depression (economics) , psychological intervention , type 2 diabetes mellitus , type 2 diabetes , logistic regression , medicine , weight management , gerontology , odds ratio , odds , demography , diabetes management , cross sectional study , clinical psychology , psychology , environmental health , psychiatry , obesity , population , weight loss , endocrinology , sociology , economics , macroeconomics , pathology
Objective: A socioeconomic gradient exists in Australia for type 2 diabetes mellitus (T2DM). It remains unclear whether economic hardship is associated with T2DM self–management behaviours. Methods: Cross‐sectional data from a subset of the Diabetes MILES – Australia study were used (n=915). The Economic Hardship Questionnaire was used to assess hardship. Outcomes included: healthy eating and physical activity (Diabetes Self‐Care Inventory – Revised), medication‐taking behaviour (Medication Adherence Rating Scales) and frequency of self‐monitoring of blood glucose (SMBG). Regression modelling was used to explore the respective relationships. Results: Greater economic hardship was significantly associated with sub‐optimal medication‐taking (Coefficient: −0.86, 95%CI −1.54, −0.18), and decreased likelihood of regular physical activity (Odds Ratio: 0.47, 0.29, 0.77). However, after adjustments for a range of variables, these relationships did not hold. Being employed and higher depression levels were significantly associated with less‐frequent SMBG, sub‐optimal medication‐taking and less‐regular healthy eating. Engaging in physical activity was strongly associated with healthy eating. Conclusions: Employment, older age and depressive symptoms, not economic hardship, were commonly associated with diabetes self‐management. Implications: Work‐based interventions that promote T2DM self‐management in younger, working populations that focus on negative emotions may be beneficial.