Diabetes delivers ‘health shock’ to education, employment for young adults

Fletcher JM. Health Aff (Millwood). 2012;31:27-34.

Issue: February 2012

Young people with diabetes not only face serious health concerns but have higher high school dropout rates, lower wages and employment rates, and can expect to earn $160,000 less during their working lives when compared with peers without the disease, according to new data published in Health Affairs.

“Diabetes has a marked effect on schooling and earnings early in life, yet these are relatively unexamined implications of the disease,” study researcher Jason M. Fletcher, PhD, associate professor of public health at Yale University, said in a press release.

Fletcher and Michael R. Richards, graduate student in the division of health policy and administration at the Yale School of Public Health, examined data from approximately 150,000 participants in the National Longitudinal Study of Adolescent Health. According to results, the high school dropout rate among those with diabetes was 6% higher than the rate among those without the disease. This disparity is larger than that observed between races or sexes in the general population and is similar in magnitude to the effects of attention-deficit/hyperactivity disorder, the researchers said. In addition, those with diabetes are also 4% to 6% less likely to attend college if they have a parent with diabetes.

The researchers also found that, by age 30 years, the likelihood of being employed is 10% lower for a person with diabetes, which is partially due to reduced education. Those with the disease also earn $6,000 less per year, or $160,000 throughout a lifetime, when compared with those without diabetes.

Overall, the early effects of diabetes on high school dropout rates and subsequent employment and wage prospects could cost society as much as $10 billion throughout the lifetime of the study cohort, the researchers said. Therefore, they recommended that policymakers focus on diabetes prevention at younger ages; researchers study children of parents with diabetes to isolate potential economic and educational spillover effects on the next generation; and health advocates promote in-school screening of diabetes at younger ages.

“Taken together, obesity and diabetes represent a severe burden on the US health care sector as well as on the larger economy,” the researchers wrote. “However, these estimates mask the more subtle point of how damaging diabetes can be in terms of human capital and a person’s earnings early in life. The early effects on education and wages can erode future health, which could leave people with diabetes trapped in an unpleasant spiral.”

Disclosure: The researchers report no relevant financial disclosures.

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