An August 2014 study revealed that diabetics who live in low-income neighborhoods are at higher risk of amputation.
One of the first things you learn when diagnosed with diabetes is that proper foot care is essential for preventing diabetic foot ulcers. Once people with this metabolic disorder encounter a scratch, cut or other abrasion, it’s crucial to their health to begin caring for it immediately and follow the treatment plan closely to minimize risk of infection – those that become gangrenous may need to be amputated to prevent the gangrene from poisoning the entire body.
All people with diabetes are at a heightened risk of amputation. However, recent research has revealed that those who live in poorer regions compared to wealthier areas may be much more likely to have a leg, foot or toe removed due to infected ulcers.
About the study
The study, titled “Geographic Clustering Of Diabetic Lower-Extremity Amputations In Low-Income Regions Of California,” was published in the journal Health Affairs in August 2014. Researchers looked at data collected by the California Health Interview Survey conducted by the UCLA Center for Health Policy Research, which determined the prevalence of this metabolic disorder among populations with low income according to zip code. These numbers were evaluated using household income statistics provided by the U.S. Census Bureau and compared to discharge data from the state’s health planning office, which tracked amputations related to diabetes according to zip code.
After much analysis, the researchers compiled maps that presented amputation rates divided by neighborhood for patients age 45 and older (the age group most at risk of amputation). These maps reveal that diabetics who lived in low-income zip codes were 10 percent more likely to have lost part of or an entire lower extremity than those in more affluent areas. To put that into perspective – in wealthy Beverly Hills and Malibu, the number of amputations did not exceed 1.5 for every 1,000 residents. In poverty-stricken Compton, on the other hand, a whopping 10.7 out of 1,000 residents has amputated legs due to diabetic ulcers.
Race also played a major role. African Americans make up less than 6 percent of the diabetic population in California, yet accounted for about 13 percent of those who underwent amputation in 2009. By contrast, Asian people made up 12 percent of the diabetic population but had a much lower amputation rate – less than 5 percent lost a leg, foot or toe in 2009.
While the study looks specifically at the state of California, the sample serves as a testament to the role that income plays in quality of and access to health care. There are fewer health care options for people of low income, and the researchers emphasized the need for earlier diagnosis and proper wound care for ulcers as a means of preventing amputation. With hope, these findings will prompt public agencies and health care providers to reach out to high-risk patients to inform them of ways to prevent amputation. Additionally, it may encourage policymakers to ease up on Medicare and Medicare obstacles around obtaining advanced wound care.