People who are poor and suffering from diabetes are 10 times more likely to lose a limb than wealthier people with the same illness, a new study finds.
Previous studies have linked many health issues with poverty. Adding to this already long list, researchers from University of California - Los Angeles Health Sciences, found that poor people suffering from diabetes are 10 times more likely to lose a limb than wealthier people with the same illness.
"I've stood at the bedsides of diabetic patients and listened to the surgical residents say, 'We have to cut your foot off to save your life,'" said lead author Dr. Carl Stevens, a clinical professor of medicine at the David Geffen School of Medicine at UCLA, according to the press release. "When you have diabetes, where you live directly relates to whether you'll lose a limb to the disease. Millions of Californians have undergone preventable amputations due to poorly managed diabetes. We hope our findings spur policymakers nationwide to improve access to treatment by expanding Medicaid and other programs targeting low-income residents, as we did in California in 2014."
For the study, researchers examined data taken from the UCLA Center for Health Policy Research's California Health Interview Survey, the U.S. Census Bureau and the Office of Statewide Health Planning and Development. The data included information about diabetic people's household-income, hospital discharge forms and zip codes. The researchers analyzed the data in combination with the amputation rate for diabetic patients aged 45 and older.
They found that around 6,800 people with diabetes lost legs, feet and toes due to complications from diabetes in 2009. Also, more than 1,000 patients needed two or more amputations. The researchers reported that the amputation rates were higher in low-income neighborhoods. Residents from these areas that had diabetes were 10 times more likely to undergo a limb amputation when compared to people with diabetes who lived in higher income neighborhoods.
"Neighborhoods with high amputation rates clustered geographically into hot spots with a greater concentration of households falling below the federal poverty level," said co-author Dylan Roby, director of health economics at the UCLA Center for Health Policy Research and an assistant professor at the UCLA Fielding School of Public Health.
The researchers also noted that the race of a person also influenced this association. They found that even though African Americans made up less than 6 percent of all diabetic people living within California, this group accounted for almost 13 percent of the patients who needed one or more amputations in 2009. Asian Americans, on the other hand, made up roughly 12 percent of the diabetic population and they had a less than 5 percent amputation rate.
"The U.S. spends more health care dollars per person than any country in the world," said co-author Dr. David Schriger, a professor of emergency medicine at the Geffen School of Medicine. "Yet we still can't organize our health care system in a way that gives everyone adequate treatment. Should we tolerate a tenfold disparity for the loss of a limb and a patient's ability to walk when we can prevent amputations with proper care?"
The study was published in the journal, Health Affairs. The project was funded by the Korein Foundation, the National Institutes of Health's National Center for Advancing Translational Science, and the UCLA Clinical and Translational Science Institute.
