Diabetic patients living in low-income neighborhoods of California are 10 times more likely to lose a toe, foot or leg compared to those living in more affluent neighborhoods, a new study conducted by researchers at UCLA reveals.
The study authors hope their findings, published in the August issue of Health Affairs
, will motivate public agencies and medical providers to reach out to patients at risk of late intervention and inspire policymakers to adopt legislation to reduce barriers to care.
"I've stood at the bedsides of diabetic patients and listened to the surgical residents say, 'We have to cut your foot off to save your life,'" said lead author Dr. Carl Stevens, a clinical professor of medicine at the David Geffen School of Medicine at UCLA. "These patients are often the family breadwinners and parents of young children people with many productive years ahead of them."
"When you have diabetes, where you live directly relates to whether you'll lose a limb to the disease," added Stevens, an emergency physician for 30 years at Harbor-UCLA Medical Center. "Millions of Californians have undergone preventable amputations due to poorly managed diabetes. We hope our findings spur policymakers nationwide to improve access to treatment by expanding Medicaid and other programs targeting low-income residents, as we did in California in 2014."
The authors used data from the UCLA Center for Health Policy Research's California Health Interview Survey, which estimated the prevalence of diabetes among low-income populations by ZIP code. They blended these statistics with household-income figures from the U.S. Census Bureau and hospital discharge data from the Office of Statewide Health Planning and Development that tracked diabetes-related amputations by ZIP code.
The result was a detailed set of maps showing diabetic amputation rates by neighborhood for patients 45 and older the age range at greatest risk for amputation from disease complications.