A recent study that examined the impact of economic insecurity on managing the disease and the use of health care resources reveals that difficulty paying for food and medications appears to be associated with poor diabetes control among patients.
According to the study, increased access to health insurance offered by the Patient Protection and Affordable Care Act may not improve diabetes control among low-income patients due to the social determinants of health such as difficulty paying for food, medications, housing or utilities.
The data for the study was collected from 411 patients at a primary care clinic, two community health centers and a specialty treatment center for diabetes in Massachusetts.
While poor diabetes control was seen in 46 percent of patients, the study found that, overall, 19.1 percent of patients reported food insecurity; 27.6 percent cited cost-related medication underuse; 10.7 percent had housing instability; 14.1 percent had trouble paying for utilities (energy insecurity); and 39.1 percent of patients reported at least one material need insecurity.
The researchers reportedly said, “Food insecurity and cost-related medication under-use may be promising targets for real-world management of diabetes mellitus.”
The study showed food insecurity was associated with greater odds of poor diabetes control and increased outpatient visits but not increased emergency department(ED)/inpatient visits.
Cost-related medication underuse was associated with poor diabetes control and increased ED/inpatient visits but not outpatient visits.
The study said, health care systems are increasingly accountable for health outcomes that have roots outside of clinical care. Due to this development, strategies that increase access to health care resources might reasonably be coupled with those that address social determinants of health, including material need insecurities.”
“In particular, food insecurity and cost-related medication underuse may be promising targets for real-world management of diabetes mellitus,” said in the study.