Press release

Income-Related Inequalities in Diabetes Have Widened Over Past Decade, CDC Study Finds

June 28, 2021 | WASHINGTON, DC

Prevalence of diabetes disproportionately impacted lower-income populations; highlights the need for increased prevention strategies

A new study from researchers at the Centers for Disease Control and Prevention (CDC) reveal income-related inequalities (IRI) in rates of diabetes exist between 2001 and 2018. The findings were presented at the virtual 81st Scientific Sessions held by the American Diabetes Association® (ADA). 

Throughout the U.S., diabetes prevalence has increased over the past two decades, disproportionately affecting low-income populations. For example, between 2011 and 2014, compared with persons with high income, the relative percentage increase in diabetes prevalence was 40.0%, 74.1%, and 100.4% for those classified as middle income, near-poor and poor, respectively. However, recent changes in income-related inequalities in diabetes prevalence are unknown. 

A study using data from the National Health Interview Survey estimated IRI in diagnosed diabetes in 2001−2018 among U.S. adults aged 18 years and older. IRI was calculated using the Concentration Index (CI) ranging from -1 to 1, with negative values indicating diabetes was concentrated among low-income groups. 

Results of the study, Income-Related Inequalities in Diagnosed Diabetes Prevalence among U.S. Adults, 2001−2018 show diabetes was more prevalent in low-income populations during 2001−2018 in the U.S. Income-related inequalities in diabetes narrowed during 2001−2011 (annual percentage change [APC] -2.5, p=0.013), and then widened in 2011−2018 (APC 4.7, p=0.004). 

Further, the income-related inequalities in diabetes differed by sex and age group. For females, the degree of inequality decreased during 2001−2012 (APC -2.5, p=0.024) and increased after 2012 (APC 4.7, p=0.097). Adults aged 45−64 years had the highest level of IRI in diabetes. The degree of inequality increased in each age group during 2001−2018 (all p<0.05).

“We found that low-income populations are more likely to have diabetes and that income-related inequalities in diabetes appear to have widened over the past decade,” said Yu Chen, Ph.D., Prevention Effectiveness Fellow in CDC’s Division of Diabetes Translation. “This research suggests addressing factors early and developing and scaling effective type 2 diabetes prevention interventions among lower-income populations can help reduce diabetes inequalities.”

The authors note that future studies are needed to further investigate the factors accounting for inequalities in diabetes prevalence.

Research presentation details: 

  • Dr. Chen and other study investigators will present their findings during a symposium listed below (Dr. Chen will speak at 4:45 p.m. ET):
  • Social and Environmental Determinates in Diabetes
  • Date: Monday, June 28 4:45–5:00 p.m. ET (all sessions will be recorded and accessible for 90 days) 

For more information or to request an interview with Dr. Chen, please contact the ADA Scientific Sessions media team at

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About the American Diabetes Association
Every day more than 4,000 people are newly diagnosed with diabetes in America. More than 122 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).


About the ADA’s Scientific Sessions
The ADA’s 81st Scientific Sessions, the world’s largest scientific meeting focused on diabetes research, prevention, and care, will be held virtually June 25–29. Leading physicians, scientists, and health care professionals from around the world will unveil cutting-edge research, treatment recommendations, and advances toward a cure for diabetes. Though the conference will be remote this year, attendees will receive exclusive access to nearly 2,000 original research presentations and take part in provocative and engaging exchanges with leading diabetes experts. Learn more and register at and join the Scientific Sessions conversation on social media using #ADA2021.