Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
• The disparity rate differences (i.e., the absolute difference of diabetes prevalence between the
lowest and highest neighbourhood income group) are increasing over time. However, the absolute
differences are consistently statistically significantly higher in rural, indicating a larger rate difference
between lowest and highest neighbourhood income groups in rural Manitoba. The rate difference
differences may be plateauing in both rural and urban neighbourhood income groups since the late
1990s.
What is this telling us?
• The socioeconomic gap in diabetes prevalence is widening over time for both rural and urban
Manitobans.
• By all measures, the socioeconomic gap is larger in rural than in urban Manitoba.
• All neighbourhood income groups in both rural and urban Manitoba show increasing diabetes
prevalence over time.
• The largest socioeconomic gap in diabetes prevalence is seen in the time period T6 (1999/00–
2001/02) for rural Manitoba, where 31.8% of the diabetes is experienced by the lowest rural
neighbourhood income group representing 18.0% of the rural population 3 , and the Gini coefficient is
0.161.
Where to from here?
• Although diabetes disparity exists, the Lorenz curves are not as steeply bent as would be expected
given the high profile of diabetes in the lower socioeconomic groups in Manitoba. So although
targeted interventions should occur for the lowest neighbourhood income quintile groups, universal
approaches need to reduce the burden of diabetes throughout the entire population.
• In both rural and urban neighbourhood income quintiles, the slope of increase becomes larger
around T4 (the mid–1990s). This may reflect better surveillance to detect diabetes in the population,
given greater incidence rates. As well, possibly greater longevity of people with diabetes due to
improved treatment would also increase prevalence due to decreased mortality.
• Diabetes prevalence has almost doubled in rural and urban Manitoba in 20 years and the prevalence
rates are higher in rural Manitoba. However, the largest rate difference between lowest and highest
neighbourhood income group is in rural Manitoba suggesting a need for targeted programs to
prevent diabetes in the R1 group especially.
3 Although Gini coefficient and Lorenz curve data are only given for the first and last time periods in this report, these data are
available on the MCHP website for all time periods (go to the MCHP website, then to Publications, then to this report, then to Data
Extras for all the Excel spreadsheet data).
Manitoba Centre for Health Policy 83