Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study

Objective: Diabetes is associated with lower labour force participation. The proportion of people having diabetes is higher among people with a low socio-economic position. We aimed to describe socio-economic differences in the association between diabetes and labour force participation in Germany....

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Main Authors: Mackowiak, Malwina M., Brinks, Ralph, Hoyer, Annika, Linnenkamp, Ute, Piedboeuf-Potyka, Katharina, Neuhäuser, Markus, Kuss, Oliver, Tönnies, Thaddäus
Format: Article
Language:deu
Published: German Medical Science GMS Publishing House 2025-06-01
Series:GMS German Medical Science
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Online Access:https://journals.publisso.de/en/journals/gms/volume23/000340
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author Mackowiak, Malwina M.
Brinks, Ralph
Hoyer, Annika
Linnenkamp, Ute
Piedboeuf-Potyka, Katharina
Neuhäuser, Markus
Kuss, Oliver
Tönnies, Thaddäus
author_facet Mackowiak, Malwina M.
Brinks, Ralph
Hoyer, Annika
Linnenkamp, Ute
Piedboeuf-Potyka, Katharina
Neuhäuser, Markus
Kuss, Oliver
Tönnies, Thaddäus
author_sort Mackowiak, Malwina M.
collection DOAJ
description Objective: Diabetes is associated with lower labour force participation. The proportion of people having diabetes is higher among people with a low socio-economic position. We aimed to describe socio-economic differences in the association between diabetes and labour force participation in Germany. Methods: Based on repeated cross-sectional data from the German Socio-Economic Panel Study, the probability for participating in labour force was modelled with a logistic regression model including diabetes status, sex, socio-economic position, survey year and age as independent variables. Analyses accounted for the complex survey design of the study and used post-stratification weights. For easier interpretation, we estimated relative risks instead of odds ratios from logistic regression using post-estimation techniques. Relative labour force participation shortfall [%] was calculated as (1 – relative risk) x 100. Results: Labour force participation among people without diabetes was 82.2% compared to 55.9% among people with diabetes. Labour force participation shortfall was higher for low socio-economic position values and decreased with increasing socio-economic position. Labour force participation shortfall was generally larger among women while the association between labour force participation shortfall and socio-economic position was stronger among men. Conclusions: Diabetes-associated labour force participation shortfall mainly affects people with low socio-economic position, which indicates that this population subgroup not only carries a higher risk of diabetes, but also might be more strongly affected by its negative impact on productivity. Future studies aiming to quantify diabetes-associated productivity losses should take associations specific to socio-economic position into account.
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institution Kabale University
issn 1612-3174
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publishDate 2025-06-01
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record_format Article
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spelling doaj-art-a5166c0a17d649a1b8bfc59876f73bd22025-08-20T03:51:19ZdeuGerman Medical Science GMS Publishing HouseGMS German Medical Science1612-31742025-06-0123Doc0410.3205/000340Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional studyMackowiak, Malwina M.0Brinks, Ralph1Hoyer, Annika2Linnenkamp, Ute3Piedboeuf-Potyka, Katharina4Neuhäuser, Markus5Kuss, Oliver6Tönnies, Thaddäus7Koblenz University of Applied Sciences, RheinAhrCampus, Department of Mathematics and Technology, Remagen, GermanyChair for Medical Biometry and Epidemiology, Witten/Herdecke University, Faculty of Health/School of Medicine, Witten, GermanyBielefeld University, Medical School OWL, Biostatistics and Medical Biometry, Bielefeld, GermanyInstitute for Health Services Research and Health Economics, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, GermanyInstitute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, GermanyKoblenz University of Applied Sciences, RheinAhrCampus, Department of Mathematics and Technology, Remagen, GermanyInstitute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, GermanyInstitute for Biometrics and Epidemiology, German Diabetes Center (DDZ), Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, GermanyObjective: Diabetes is associated with lower labour force participation. The proportion of people having diabetes is higher among people with a low socio-economic position. We aimed to describe socio-economic differences in the association between diabetes and labour force participation in Germany. Methods: Based on repeated cross-sectional data from the German Socio-Economic Panel Study, the probability for participating in labour force was modelled with a logistic regression model including diabetes status, sex, socio-economic position, survey year and age as independent variables. Analyses accounted for the complex survey design of the study and used post-stratification weights. For easier interpretation, we estimated relative risks instead of odds ratios from logistic regression using post-estimation techniques. Relative labour force participation shortfall [%] was calculated as (1 – relative risk) x 100. Results: Labour force participation among people without diabetes was 82.2% compared to 55.9% among people with diabetes. Labour force participation shortfall was higher for low socio-economic position values and decreased with increasing socio-economic position. Labour force participation shortfall was generally larger among women while the association between labour force participation shortfall and socio-economic position was stronger among men. Conclusions: Diabetes-associated labour force participation shortfall mainly affects people with low socio-economic position, which indicates that this population subgroup not only carries a higher risk of diabetes, but also might be more strongly affected by its negative impact on productivity. Future studies aiming to quantify diabetes-associated productivity losses should take associations specific to socio-economic position into account.https://journals.publisso.de/en/journals/gms/volume23/000340diabeteslabour force participationsocio-economic positionlogistic regressionrelative shortfall
spellingShingle Mackowiak, Malwina M.
Brinks, Ralph
Hoyer, Annika
Linnenkamp, Ute
Piedboeuf-Potyka, Katharina
Neuhäuser, Markus
Kuss, Oliver
Tönnies, Thaddäus
Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study
GMS German Medical Science
diabetes
labour force participation
socio-economic position
logistic regression
relative shortfall
title Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study
title_full Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study
title_fullStr Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study
title_full_unstemmed Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study
title_short Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study
title_sort socio economic inequalities in the association between diabetes and labour force participation in germany a repeated cross sectional study
topic diabetes
labour force participation
socio-economic position
logistic regression
relative shortfall
url https://journals.publisso.de/en/journals/gms/volume23/000340
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