Socioeconomic inequalities in type 2 diabetes comorbidities in different population subgroups: trend analyses using German health insurance data

Safieddine, Batoul; Sperlich, Stefanie; Beller, Johannes; Lange, Karin; Geyer, Siegfried

doi:10.1038/s41598-023-37951-y

Cited by 3 publications

(1 citation statement)

References 54 publications

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“…This hypothesis is also in line with recent increasing trends in type 2 diabetes [ 43 ]. For example, recent evidence points towards a significant increase in type 2 diabetes complications and comorbidities in working-age individuals [ 44 , 45 ]. However, again, more research is needed to formally study the reasons for the observed changes in health over time [ 28 , 46 , 47 ].…”

Section: Discussionmentioning

confidence: 99%

Physical working conditions over time: a repeated cross-sectional study in German employees

Beller,

Graßhoff,

Safieddine

2024

J Occup Med Toxicol

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Background This study aimed to examine time trends in physical working conditions across and within occupational groups in Germany between 2006 and 2018. Methods Logistic regression analyses were conducted using data from the BIBB/BAuA Employment Surveys in 2006, 2012, and 2018, with a total sample size of 59,006 participants. The study investigated changes in various self-reported occupational exposure measures over time, along with demographic shifts in the workforce. Results The results showed overall improvements in most occupational exposure measures during the study period, alongside an aging and upskilling workforce. However, exposure to awkward postures, microorganisms, and, to a lesser extent, noise increased. Substantial variation was observed between occupational groups, with more favourable trends among white-collar high-skilled and blue-collar low-skilled workers, and less favourable trends among white-collar low-skilled and blue-collar high-skilled workers. Conclusions While trends in physical working conditions in Germany are partly promising, some exposures are worsening, and substantial inequalities between occupations persist. As occupational exposures remain common, there is still a need for targeted interventions to improve working conditions, particularly in higher-risk occupations.

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Section: Discussionmentioning

confidence: 99%

Physical working conditions over time: a repeated cross-sectional study in German employees

Beller,

Graßhoff,

Safieddine

2024

J Occup Med Toxicol

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Type 2 diabetes in the employed population: do rates and trends differ among nine occupational sectors? An analysis using German health insurance claims data

Safieddine,

Grasshoff,

Geyer

et al. 2024

BMC Public Health

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Background Socioeconomic inequalities in type 2 diabetes (T2D) are well established in the literature. However, within the background of changing work contexts associated with digitalization and its effect on lifestyle and sedentary behavior, little is known on T2D prevalence and trends among different occupational groups. This study aims to examine occupational sector differences in T2D prevalence and trends thereof between 2012 and 2019. Methods The study was done on 1.683.644 employed individuals using data from the German statutory health insurance provider in Lower Saxony, the “Allgemeine Ortskrankenkasse Niedersachsen” (AOKN). Predicted probabilities for T2D prevalence in four two-year periods between 2012 and 2019 were estimated based on logistic regression analyses for nine occupational sectors. Prevalence ratios were calculated to illustrate the effect of time period on the prevalence of T2D among the nine occupational sectors. Analyses were stratified by gender and two age groups. Results Results showed differences among occupational sectors in the predicted probabilities for T2D. The occupational sectors “Transport, logistics, protection and security” and “Health sector, social work, teaching & education” had the highest predicted probabilities, while those working in the sector “Agriculture” had by far the lowest predicted probabilities for T2D. Over all, there appeared to be a rising trend in T2D prevalence among younger employed individuals, with gender differences among occupational sectors. Conclusion The study displayed different vulnerability levels among occupational sectors with respect to T2D prevalence overall and for its rising trend among the younger age group. Specific occupations within the vulnerable sectors need to be focused upon in further research to define specific target groups to which T2D prevention interventions should be tailored.

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Type 2 diabetes severity in the workforce: An occupational sector analysis using German claims data

Safieddine,

Grasshoff,

Sperlich

et al. 2024

PLoS ONE

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Background Individuals of working age spend a significant amount of time at the workplace making it an important context for disease prevention and management. The temporal development and prevalence of T2D have been shown to differ in the working population based on gender, age group and occupational sector regardless of socioeconomic status. Given potential differences in risk factors associated with different work environments, this study aims to define vulnerable occupational groups by examining T2D severity and its trends in working men and women with T2D of two age groups and among nine occupational sectors. Methods The study is based on claims data of the statutory health insurance provider AOKN. The study population consisted of all insured working individuals with T2D. T2D severity was measured using the adapted diabetes complications severity index—complication count (DCSI-CC). Mean DCSI-CC scores were calculated over four time periods between 2012 and 2019 for men and women of the age groups 18–45 and 46+ years and among nine occupational sectors. Trends of DCSI-CC were investigated using ordinal logistic regression analyses to examine the effect of time-period on the odds of having higher DCSI scores. Results Overall, there was a significant rise in T2D severity over time in working men and women of the older age group. Moreover, the study displayed occupational sector differences in T2D severity and its trends. Over all, working men of all sectors had higher DCSI-CC scores compared to working women. Individuals working in the sector “Transport, logistics, protection and security” and “Construction, architecture, measuring and building technology” had higher T2D severity, while those working in the “Health sector, social work, teaching & education” had relatively lower T2D severity. There was a gender-specific significant increase over time in T2D severity in the above-mentioned occupational sectors. Conclusion The study displayed gender, age group and occupational sector differences in T2D severity and its trends. Working individuals could thus benefit from personalized prevention interventions that consider occupational contexts. As a next step, examining T2D trends and severity in specific occupations within the vulnerable occupational sectors is needed.

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Socioeconomic inequalities in type 2 diabetes comorbidities in different population subgroups: trend analyses using German health insurance data

Cited by 3 publications

References 54 publications

Physical working conditions over time: a repeated cross-sectional study in German employees

Physical working conditions over time: a repeated cross-sectional study in German employees

Type 2 diabetes in the employed population: do rates and trends differ among nine occupational sectors? An analysis using German health insurance claims data

Type 2 diabetes severity in the workforce: An occupational sector analysis using German claims data

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