Growing Income-Related Disparities in Cardiovascular Hospitalizations Among People With Diabetes, 1995–2019: A Population-Based Study
Authors' conclusion
During a quarter-century of follow-up, cardiovascular hospitalization rates among people with diabetes fell. However, the apparent stabilization in rates of stroke, heart failure, and amputation in recent years masks the fact that rates have risen for lower-income individuals.
Study context
- Population
- Entire population of Ontario, Canada, with diagnosed diabetes, 1995–2019nearly
- Participants
- 1.7 million participants
- Exposure
- Trends over time and by income level
- Outcome
- Rates of hospitalization for acute MI, stroke, HF and lower-extremity amputation
- Follow-up
- 1995 to 2019
Methodological detailsannual cohorts, stratified by age, sex and income level
- Annual cohorts
- Stratified by age, sex and income level
Main finding
As reported in the abstract
Cardiovascular hospitalization rate trends · 1995–2019
- Acute MI rate declined throughout the 25-year period; 2019 rate less than half the 1995 rate
- P < 0.0001
- Stroke rates changed over time, stabilized through the 2010s
- P < 0.0001
- HF rates changed over time, stabilized through the 2010s
- P < 0.0001
- Amputation rates changed over time, stabilized through the 2010s
- P < 0.0001
Observational data: associations, not effects.
Further findings
Income-related disparity in trends during the 2010s
- Wealthier patients: continued declines; lower-income patients: rates increased
- P for interaction < 0.0001 for all four outcomes
Original publication
Growing Income-Related Disparities in Cardiovascular Hospitalizations Among People With Diabetes, 1995–2019: A Population-Based Study. Diabetes Care. Published 31 January 2023. doi:10.
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