Parra-Mujica, Fiorella and Roope, Laurence SJ. and Abdul-Aziz, Alia and Mustapha, Feisul and Ng, Chiu Wan and Rampal, Sanjay and Lim, Lee-Ling and Dakin, Helen and Clarke, Philip (2024) Health poverty among people with type 2 diabetes mellitus (T2DM) in Malaysia. Social Science and Medicine, 340. ISSN 0277-9536, DOI https://doi.org/10.1016/j.socscimed.2023.116426.
Full text not available from this repository.Abstract
In the context of the escalating burden of diabetes in low and middle-income countries (LMICs), there is a pressing concern about the widening disparities in care and outcomes across socioeconomic groups. This paper estimates health poverty measures among individuals with type 2 diabetes mellitus (T2DM) in Malaysia. Using data from the National Diabetes Registry between 2009 and 2018, the study linked 932,855 people with T2DM aged 40–75 to death records. Cox proportional hazards models were used to estimate the 5-year survival probabilities for each patient, stratified by age and sex, while controlling for comorbidities and area-based indicators of socio-economic status (SES), such as district-level asset-based indices and night-time luminosity. Measures of health poverty, based on the Foster-Greer-Thorbecke (FGT) measures, were employed to capture excessive risk of premature mortality. Two poverty line thresholds were used, namely a 5 and 10 reduction in survival probability compared to age and sex-adjusted survival probability of the general population. Counterfactual simulations estimated the extent to which comorbidities contribute to health poverty. 43.5 of the sample experienced health poverty using the 5 threshold, and 8.9 were health poor using the 10 threshold. Comorbidities contribute 2.9 for males and 5.4 for females, at the 5 threshold. At the 10 threshold, they contribute 7.4 for males and 3.4 for females. If all patients lived in areas of highest night-light intensity, poverty would fall by 5.8 for males and 4.6 for females at the 5 threshold, and 4.1 for males and 0.8 for females at the 10 threshold. In Malaysia, there is a high incidence of health poverty among people with diabetes, and it is strongly associated with comorbidities and area-based measures of SES. Expanding the application of health poverty measurement, through a combination of clinical registries and open spatial data, can facilitate simulations for health poverty alleviation. © 2023 The Authors
| Item Type: | Article |
|---|---|
| Funders: | UK-Malaysia Joint Partnership on Non-Communicable Diseases under the Malaysia Partnership and Alliances in Research (MyPAiR) - Ministry of Education, Malaysia [Grant no. IF076-2019], Medical Research Council (UK-Malaysia) [Grant no. MR/T018593/1], National Institutes of Health Research (NIHR) |
| Uncontrolled Keywords: | Health poverty; Inequality; Diabetes; T2DM; Luminosity |
| Subjects: | R Medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine |
| Divisions: | Faculty of Medicine > Medicine Department Faculty of Medicine > Social & Preventive Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 12 Mar 2024 02:33 |
| Last Modified: | 12 Mar 2024 02:33 |
| URI: | http://eprints.um.edu.my/id/eprint/45058 |
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