Diabetes increases financial burden of individuals with traumatic spinal cord injury (TSCI).
METHODS
Secondary analysis of existing data.


OBJECTIVE
To estimate the association of diabetes with family income in a pooled 15-year cohort of individuals with TSCI.


METHODS
A large specialty hospital in the southeastern United States.


METHODS
A total number of 1408 individuals identified with TSCI were surveyed regarding family income as well as clinical and demographic factors. Due to income being reported in censored intervals rather than individual dollar values, interval regression was used to estimate models of the association of family income with diabetes.


RESULTS
Approximately 12% of individuals with TSCI reported being diagnosed with diabetes. The most frequent family income interval in our sample was <$10,000, lower than the poverty threshold. The family income interval with the highest rate of diabetes was $15,000-$20,000. In an unadjusted model, diabetes was associated with a significant reduction of $8749 and in a fully adjusted model, diabetes was significantly associated with a reduction of $8560 in family income. Being a minority was also significantly associated with a reduction whereas educational attainment was associated with increased family income. TSCI severity was not significantly related to family income.


CONCLUSIONS
Diabetes imposes an additional financial burden on individuals with TSCI an already vulnerable population with high health care costs. The burden is more pronounced in minorities with TSCI. Providers should be aware of the higher prevalence of diabetes among patients with TSCI and pursue a policy of testing early and vigilant management. Further studies are needed regarding special interventions for managing diabetes in the TSCI population.
1] Health Equity and Rural Outreach Innovation Center, Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, USA [2] Center for Health Disparities Research, Division of General Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
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1] Health Equity and Rural Outreach Innovation Center, Ralph H Johnson Veterans Affairs Medical Center, Charleston, SC, USA [2] Center for Health Disparities Research, Division of General Internal Medicine, Medical University of South Carolina, Charleston, SC, USA.
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Egede
Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
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Saunders
Department of Health Sciences and Research, College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
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Krause
D000328:Adult; D017281:Cost of Illness; D048909:Diabetes Complications / Q000191:economics* / Q000453:epidemiology; D004522:Educational Status; D005260:Female; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000191:economics* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult