Social determinants of diabetes-related foot disease among older adults in New South Wales, Australia: evidence from a population-based study

Journal of Foot and Ankle Research

Deborah Turner¹  Frances Henshaw²  Moin Uddin Ahmed³  Wadad Kathy Tannous⁴  David Simmons⁵  Kingsley Emwinyore Agho⁶ 

[1] School of Clinical Sciences, Podiatric Medicine, Kelvin Grove Campus, Queensland University of Technology, 4059, Brisbane, QLD, Australia;School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;ConvaTec, Building 5, Brandon Business Park, 530 Springvale Rd, 3150, Glen Waverley, VIC, Australia;Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;Department of Economics, Finance and Property, School of Business, Western Sydney University, Parramatta Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;Macarthur Clinical School, Western Sydney University, 2560, Campbelltown, NSW, Australia;Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;School of Health Sciences, Western Sydney University, Campbelltown Campus, Locked Bag 1797, 2571, Penrith, NSW, Australia;African Vision Research Institute (AVRI), University of KwaZulu-Natal, 4041, Durban, South Africa;

关键词: Diabetic foot;    Social determinants of health;    Older adults;    Australia;    45 and Up Study;    Linked data;   

DOI  :  10.1186/s13047-021-00501-8

来源: Springer

【 摘 要 】

BackgroundDiabetes-related foot is the largest burden to the health sector compared to other diabetes-related complications in Australia, including New South Wales (NSW). Understanding of social determinants of diabetes-related foot disease has not been definitive in Australian studies. This study aimed to investigate the social determinants of diabetes-related foot disease in NSW.MethodologyThe first wave of the 45 and Up Study survey data was linked with NSW Admitted Patient Data Collection, Emergency Department Data Collection, and Pharmaceutical Benefits Scheme data resulting in 28,210 individuals with diabetes aged 45 years and older in NSW, Australia. Three outcome variables were used: diabetes-related foot disease (DFD), diabetic foot ulcer (DFU), and diabetic foot infection (DFI). They were classified as binary, and survey logistic regression was used to determine the association between each outcome measure and associated factors after adjusting for sampling weights.ResultsThe prevalence of DFD, DFU and DFI were 10.8%, 5.4% and 5.2%, respectively, among people with diabetes. Multivariate analyses revealed that the common factors associated with DFD, DFU and DFI were older age (75 years or more), male, single status, background in English speaking countries, and coming from lower-income households (less than AUD 20,000 per year). Furthermore, common lifestyle and health factors associated with DFD, DFU, and DFI were low physical activity (< 150 min of moderate-to-vigorous physical activity per week), history of diabetes for over 15 years, and having cardiovascular disease.ConclusionOur study showed that about 1 in 10 adults with diabetes aged 45 years and older in NSW reported DFD. Interventions, including the provision of related health services aimed at reducing all forms of DFD in NSW, are recommended to target older individuals with a long history of diabetes, and coming from lower-income households.

【 授权许可】

CC BY