Get access

Associations between economic hardship and markers of self-management in adults with type 2 diabetes: results from Diabetes MILES – Australia

Authors

  • Adrienne O'Neil,

    Corresponding author
    1. IMPACT Strategic Research Centre, Deakin University, Victoria
    2. School of Public Health and Preventive Medicine, Monash University, Victoria
    • Correspondence to: Dr Adrienne O'Neil, School of Medicine, Deakin University, PO Box 281, Geelong, VIC 3220; e-mail: AONEIL@barwonhealth.org.au

    Search for more papers by this author
  • Emily D. Williams,

    1. School of Public Health and Preventive Medicine, Monash University, Victoria
    2. National Heart and Lung Institute, Imperial College London, UK
    Search for more papers by this author
  • Jessica L. Browne,

    1. The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Vic, Victoria
    2. Centre for Mental Health & Wellbeing Research, School of Psychology, Deakin University, Victoria
    Search for more papers by this author
  • Rob Horne,

    1. School of Pharmacy, University College London, UK
    Search for more papers by this author
  • Frans Pouwer,

    1. Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases, Tilburg University, The Netherlands
    Search for more papers by this author
  • Jane Speight

    1. The Australian Centre for Behavioural Research in Diabetes, Diabetes Australia – Vic, Victoria
    2. Centre for Mental Health & Wellbeing Research, School of Psychology, Deakin University, Victoria
    3. AHP Research, Essex, UK
    Search for more papers by this author

  • The authors have stated they have no conflict of interest.

Abstract

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.

Get access to the full text of this article

Ancillary