Decomposing Socioeconomic Inequality in Lean Diabetes among Middle-Aged Adults and Elderly in India

Abhishek Kumar, International Institute for Population Sciences (IIPS)
Suraj Maiti, Virginia Tech

Lean diabetes is a subtype of diabetes (BMI < 18.5 Kg/m 2) with severe microvascular complications. We decompose the socioeconomic inequalities in lean diabetes among middle-aged adults and elderly in India. Longitudinal Ageing Study in India (LASI) wave-1 microdata with a complete case analytic sample size of 58,824 individuals (45+) were utilised. We combined self-reported medically diagnosed diabetic conditions with BMI and identified lean diabetic cases. Descriptive statistics and multivariable logistic regression were used to examine the prevalence and predictors of lean diabetes. Erreygers’ concentration index (ECI) and decomposition analyses were used to examine the contribution of socioeconomic factors in lean diabetes. The prevalence of lean diabetes among older adults was 0.8% (95% CI: 0.7%,0.9%). A negative ECI (-.006) suggests pro-poor inequality in lean diabetes. The decomposition shows that the economic condition of households measured by monthly per capita consumption expenditure explains the largest variation in socio-economic inequality of lean diabetes (72%) followed by the place of residence (24%) and education (20%). The health care system in India needs to pay attention to the high burden of lean diabetes among the socially and economically disadvantaged populations in the diabetes care cascade. Key Words: Diabetes, lean diabetes, inequality, concentration index, India

Keywords: Decomposition analysis, Health and Morbidity, Population Ageing, Inequality, Disadvantage and Discrimination

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