The authors have stated they have no conflict of interest.
Associations between economic hardship and markers of self-management in adults with type 2 diabetes: results from Diabetes MILES – Australia
Article first published online: 22 APR 2014
© 2014 Public Health Association of Australia
Australian and New Zealand Journal of Public Health
Special Issue: The Ebola crisis – is Australia prepared?
Volume 38, Issue 5, pages 466–472, October 2014
How to Cite
O'Neil, A., Williams, E. D., Browne, J. L., Horne, R., Pouwer, F. and Speight, J. (2014), Associations between economic hardship and markers of self-management in adults with type 2 diabetes: results from Diabetes MILES – Australia. Australian and New Zealand Journal of Public Health, 38: 466–472. doi: 10.1111/1753-6405.12153
- Issue published online: 30 SEP 2014
- Article first published online: 22 APR 2014
- Manuscript Accepted: 1 SEP 2013
- Manuscript Revised: 1 AUG 2013
- Manuscript Received: 1 JUN 2013
- economic hardship;
- type 2 diabetes mellitus;
- blood glucose monitoring;
- medication taking
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.