PMID- 38016309
OWN - NLM
STAT- MEDLINE
DCOM- 20240122
LR  - 20240320
IS  - 1873-5347 (Electronic)
IS  - 0277-9536 (Linking)
VI  - 340
DP  - 2024 Jan
TI  - Health poverty among people with type 2 diabetes mellitus (T2DM) in Malaysia.
PG  - 116426
LID - S0277-9536(23)00783-9 [pii]
LID - 10.1016/j.socscimed.2023.116426 [doi]
AB  - 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.
CI  - Copyright (c) 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
FAU - Parra-Mujica, Fiorella
AU  - Parra-Mujica F
AD  - Erasmus School of Health Policy and Management (ESHPM), Erasmus, University 
      Rotterdam, the Netherlands; Health Economics Research Centre, Nuffield Department 
      of Population Health, University of Oxford, Oxford, United Kingdom; Erasmus 
      Center for Health Economics Rotterdam (EsCHER), the Netherlands. Electronic 
      address: parramujica@eshpm.eur.nl.
FAU - Roope, Laurence Sj
AU  - Roope LS
AD  - Health Economics Research Centre, Nuffield Department of Population Health, 
      University of Oxford, Oxford, United Kingdom.
FAU - Abdul-Aziz, Alia
AU  - Abdul-Aziz A
AD  - Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, 
      Malaysia.
FAU - Mustapha, Feisul
AU  - Mustapha F
AD  - Non-communicable Disease Section, Disease Control Division, Ministry of Health, 
      Putrajaya, Malaysia.
FAU - Ng, Chiu Wan
AU  - Ng CW
AD  - Department of Social and Preventive Medicine, Faculty of Medicine, University of 
      Malaya, Kuala Lumpur, Malaysia.
FAU - Rampal, Sanjay
AU  - Rampal S
AD  - Department of Social and Preventive Medicine, Faculty of Medicine, University of 
      Malaya, Kuala Lumpur, Malaysia.
FAU - Lim, Lee-Ling
AU  - Lim LL
AD  - Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, 
      Malaysia; Department of Medicine and Therapeutics, The Chinese University of Hong 
      Kong, Hong Kong SAR, China.
FAU - Dakin, Helen
AU  - Dakin H
AD  - Health Economics Research Centre, Nuffield Department of Population Health, 
      University of Oxford, Oxford, United Kingdom.
FAU - Clarke, Philip
AU  - Clarke P
AD  - Health Economics Research Centre, Nuffield Department of Population Health, 
      University of Oxford, Oxford, United Kingdom.
LA  - eng
GR  - MR/T018593/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
DEP - 20231122
PL  - England
TA  - Soc Sci Med
JT  - Social science & medicine (1982)
JID - 8303205
SB  - IM
MH  - Male
MH  - Female
MH  - Humans
MH  - *Diabetes Mellitus, Type 2/epidemiology
MH  - Poverty
MH  - Malaysia/epidemiology
MH  - Social Class
MH  - Comorbidity
MH  - Socioeconomic Factors
OTO - NOTNLM
OT  - Diabetes
OT  - Health poverty
OT  - Inequality
OT  - Luminosity
OT  - T2DM
EDAT- 2023/11/29 00:42
MHDA- 2024/01/22 06:43
CRDT- 2023/11/28 18:07
PHST- 2023/06/26 00:00 [received]
PHST- 2023/11/06 00:00 [revised]
PHST- 2023/11/10 00:00 [accepted]
PHST- 2024/01/22 06:43 [medline]
PHST- 2023/11/29 00:42 [pubmed]
PHST- 2023/11/28 18:07 [entrez]
AID - S0277-9536(23)00783-9 [pii]
AID - 10.1016/j.socscimed.2023.116426 [doi]
PST - ppublish
SO  - Soc Sci Med. 2024 Jan;340:116426. doi: 10.1016/j.socscimed.2023.116426. Epub 2023 
      Nov 22.