Health inequalities in different age groups: the case of type 2-diabetes: a study with health insurance and medication data

Summary Objectives:This study investigates social differentials in the prevalence of diabetes type 2 in women and men in a health insurance population. It is considered whether social gradients are present over different age strata. Methods:Analyses were performed with records obtained from a German statutory health insurance comprising 77294 women (31.8%) and men (68.2%) of at least 20 years. Occupational status was used as indicator of socio-economic position. Individuals with diabetes were identified using information about antidiabetic medication or by hospital diagnoses according to ICD9. The analyses were performed for the entire insurance population and for different age strata (<40yrs/40–55yrs/>55yrs). Results:The analyses revealed considerable social differences in diabetes risks. Considering the whole insurance population with the highest socio-economic category as reference group, the odds ratio (OR) for skilled non-manuals was OR=2.9, for skilled manuals it was OR=4.7, and OR=5.6 for unskilled and semi-skilled individuals. After stratifying the insurance population into three age groups the social gradients were reproduced for each stratum, but their magnitudes increased with age. Conclusions:In the health insurance population considered health inequalities with respect to diabetes are considerable, and they are persisting after stratification into age groups.