Development of a socioeconomic index to measure disparities in adults with diabetes, Puerto Rico, 2009

Socioeconomic status is one of the social determinants of health. The Behavioral Risk Factor Surveillance System (BRFSS) collects data on three major socioeconomic indicators: education level, annual household income, and employment status. The use of only one socioeconomic indicator as a predictor of socioeconomic position may not reflect the reality of the Puerto Rican population. The study aims to describe the socioeconomic profile of adults with diabetes in Puerto Rico (PR), to develop a socioeconomic index (SEI), and to determine if there is a difference between adults with diabetes and those without it in terms of their socioeconomic status. Data gathered from the 2009 PR BRFSS were analyzed to describe the socioeconomic characteristics of adults with diabetes. The SEI, generated by integrating the three socioeconomic indicators, comprised three categories: low, middle, and high levels. Descriptive statistics and Pearson's Chi-square test were used in the analysis. In 2009, the prevalence of diabetes in adults in PR was 12.9%. Almost 60% of the adults with diabetes belonged to low socioeconomic level. In contrast, the majority of the adults without diabetes (62.1%) were in middle or high socioeconomic levels. The percentage of adults with diabetes and those without it differ significantly in terms of socioeconomic status (low: 59.9% vs 37.9%; middle: 26.3% vs 38.8%; high: 13.8% vs 23.3%) (p < 0.001). The study provides additional evidence of the inverse association between socioeconomic status and diabetes. Further research is needed to identify why risk factors implicated in diabetes are more prevalent in underprivileged areas.