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Socioeconomic Status and the Domestic Allocation of Type 1 Diabetes Care

Ashby F. Walker, PhD, Desmond A. Schatz, MD, Cathryn Johnson, PhD, Henry J. Rohrs, MD, Kelsey R. Salazar, MPH

Abstract

Objective: Few studies explore how socioeconomic status (SES) influences the allocation of type 1 diabetes (T1D) care within households. This study used survey research to better understand the perspectives and experiences of maternal caregivers who have adolescents with T1D.

Research Design and Methods: Survey research with open-ended sections was conducted with women who live with another adult partner and had full custody of an adolescent 12-19 with T1D. Demographic information included age, gender, race-ethnicity, martial status, education level, occupation, and household income. Disease duration and youth HbA1c levels were also captured.

Results: Forty-six caregivers completed surveys. Care allocation, diabetes strain, and parenting strategies were compared by income categories and exhibited variation accordingly. Women from households with income <$40,000, classified as low socio-economic status or less affluent, tended to report sharing diabetes-related responsibilities equally with partners; tended to hold full-time, low-wage positions; and noted stress associated with inflexible jobs and financial concerns. Women from households with incomes $80,000 or higher, classified as high socioeconomic status or more affluent, more commonly described primary caregiving, professional status changes, and difficulty transferring control to their teens.

Conclusion: These findings indicate significant, yet varying, strain for women from different SES thresholds that deserves further attention. For female caregivers of adolescents with T1D, the unequal distribution of labor associated with care-related demands may contribute to outcomes like depression, anxiety, and familial conflict.  Providers should be acutely aware of the toll that care-related demands may take on women and have information readily available on support groups and mental health services.


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DOI: http://dx.doi.org/10.17125/plaid.2017.97

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