Socio-economic gradients in self-reported diabetes for Indigenous and non-Indigenous Australians aged 18-64.

OBJECTIVE

To examine and compare socio-economic gradients in diabetes among Indigenous and non-Indigenous Australians.

METHODS

I analysed weighted data on self-reported diabetes and a range of socio-economic status (SES) measures for 5,417 Indigenous and 15,432 non-Indigenous adults aged 18-64 years from two nationally representative surveys conducted in parallel by the Australian Bureau of Statistics in 2004-05.

RESULTS

After adjusting for age, diabetes prevalence was significantly higher among those of lower SES in both Indigenous and non-Indigenous populations. The age- and sex-adjusted odds ratios (OR) for diabetes for the lowest versus the highest SES group were similar for the two populations on many variables. For example, the OR for the lowest quintile of equivalised household income (compared with quintiles 3-5 combined) was 2.3 (95% CI 1.6-3.4) for the Indigenous population and 2.0 (95% CI 1.5-2.8) for the non-Indigenous population. However, Indigenous people of high SES had greater diabetes prevalence than low SES non-Indigenous people on every SES measure examined.

CONCLUSION

Socio-economic status explains some but not all of the difference in diabetes prevalence between Indigenous and non-Indigenous Australians. Other factors that may operate across the socio-economic spectrum, such as racism, stress, loss and grief, may also be relevant and warrant further examination.

IMPLICATIONS

Indigenous Australians do not constitute a homogeneous group with respect to socio-economic status or diabetes prevalence, and this diversity must be recognised in developing measures to redress Indigenous health disadvantage.