Socioeconomic Inequalities In Health Among Type 2 Diabetes Patients

Abstract

Background: This study assessed the socioeconomic inequalities in in health among patients with type 2 diabetes mellitus (T2DM) and evaluated the role of social capital. Social capital has been considered as an essential though intangible resource towards provision of healthcare services. Given the rising concern of socioeconomic inequalities in population health and the rising burden of diabetes in the country, understanding the extent of these inequalities in diabetes control is important in strengthening healthcare systems. Social capital provides useful insights into how social networks of persons and communities can be employed to boost the desired results for the person and the community in regards to their health. The current prevalence rate of Diabetes in Kenya is at 4.56%. In addition, about 14% of Kenyans have impaired glucose tolerance; a pre-diabetic state. There are more cases of diabetes in urban as compared to rural areas in Kenya. Objectives: There is limited literature available on the role of social capital among diabetes patients in Kenya. The study sought to find out: The association between social capital and glycaemic control among type 2 diabetes patients; the estimated socioeconomic inequalities in health among type 2 diabetes patients and establish the link between social capital and socioeconomic inequalities in glycaemic control among type 2 diabetes patients. Methodology: This was a cross-sectional study design with a sample size of 363 individuals with T2DM aged between 20 and 79 were selected through systematic random sampling approach and interviewed using semi-structured questionnaires at the Nakuru level V Hospital (NKLVH). Marginal effects analysis was used to estimate the determinants of glycaemic control and concentration index to estimate socioeconomic inequalities in glycaemic control and Random Blood Sugar control. Findings: The results from probit regression showed that the chi square for likelihood ratio test was significant suggesting that the independent variables jointly influenced glycaemic control. The concentration index illustrated that good glycaemic control was concentrated among T2DM patients in higher income categories. When the concentration index was conducted comparing the T2DM patients in support groups and those not in support groups, there was no significant difference demonstrating that social capital was not influencing socioeconomic inequality among the T2DM patients in Nakuru County. In the probit regression analysis, not being a member of the support group had a negative effect on glycaemic control. Conclusion: Based on the findings, it was observed that there exists inequity in glycaemic control among T2DM patients in Nakuru County. Social capital was found not to influence inequalities in glycaemic control. However, living in urban area, having secondary and above education and being female significantly caused inequality in T2DM control. To improve management and control of T2DM, the government needs to address socioeconomic inequalities associated with glycaemic control and random blood sugar control.