Socioeconomic disparities in diabetes prevalence among the population in Ireland

A large variation in diabetes prevalence by socioeconomic status (SES) persists internationally. This study aimed to quantify the prevalence of diabetes by age and SES and explore the current levels of inequality in the prevalence of diabetes in Ireland.

Annual cross-sectional self-reported diabetes data from the national population-based Healthy Ireland Survey for 2015-2023 (n = 59,933) were utilised. Highest educational attainment and area-based deprivation were used as SES indicators. Additionally, the differences in diabetes prevalence across population age-groups were reported. Socioeconomic differences and change in inequality over time were quantified using the relative index of inequality (RII). Logistic regression was used to estimate the relative risk (RR) for having self-reported diabetes according to age and SES, adjusted for sex and survey year.

Diabetes prevalence was highest among individuals aged > 75 years (13.1%) compared to those aged < 40 years (1.0%). Similarly, prevalence was highest among the least educated (8.1%; RR = 2.73; 95% CI = 2.38, 3.13) compared to most educated (1.7%) and individuals living in most deprived areas (6.0%; RR = 2.18; 95% CI = 1.76, 2.70) compared to least deprived areas (2.2%). Additionally, the magnitude of relative inequalities as determined by education level were more than twofold greater than the magnitude of inequalities determined by area-based deprivation. Relative inequalities among individuals with diabetes persisted over the period 2015-2023 among the least educated (RII = 3.9; 95% CI = 3.3,4.6) and individuals living in the most deprived areas (RII = 3.65; 95% CI = 2.4,5.5). A slight increase in relative inequalities among the least educated, and a slight decline in relative inequalities among the most deprived was observed, however, these changes over time were not statistically significant.

This is the first study to examine the socioeconomic variation of diabetes prevalence at the Irish population level. Significant differences in diabetes prevalence persist. With the ageing Irish population, this study highlights the need to consider potential effects of diabetes across the older populations and the lowest socioeconomic status groups when implementing equity-oriented diabetes prevention and management programmes.