A recent study in Harbin reveals small but significant income-linked gaps in health-related quality of life among diabetes patients, highlighting the need for targeted community interventions beyond glycaemic control.
A study published in Dove Press has found that diabetes patients receiving primary care in a cold-region city in north-east China experienced a small but statistically significant gap in health-related quality of life that favoured higher-income groups.
The cross-sectional research, carried out in July 2025 at two community health centres in Harbin, looked at 433 adults with diabetes and used the EQ-5D-5L and EQ-VAS tools to measure quality of life. The authors reported that average scores were relatively high, with pain and discomfort the most common problem, but income-related differences still emerged. The study found that the pattern remained after adjusting for age, sex and multimorbidity, suggesting that the inequality was driven mainly by avoidable social and health-system factors rather than by unavoidable differences in need.
Household income was the biggest contributor to the gap in both measures, accounting for most of the observed inequality in the analysis. Other factors also mattered, including blood glucose control, exercise habits, marital status, digital health literacy and adherence to chronic disease follow-up. The researchers said the results point to the importance of looking beyond glycaemic control alone when judging diabetes care, particularly in community settings where long-term self-management and access to services can shape everyday wellbeing.
The findings also showed that the two quality-of-life measures did not always move in the same direction. Healthcare access measures such as family doctor contracting and follow-up adherence played a larger role in the EQ-VAS results, while blood glucose control contributed more to the EQ-5D-5L findings. The authors said this underlines the value of using more than one outcome measure when assessing inequalities in chronic disease care.
They cautioned, however, that the study was observational and cannot prove cause and effect. The sample came from two urban health centres in one city, and several important clinical factors, including diabetes duration, HbA1c and complications, were not measured. Even so, the researchers concluded that the results add to evidence that income-linked gaps in quality of life persist among people with diabetes and may require more targeted community-level support.
Disclaimer: This content is for informational purposes only and is not intended to be a substitute for professional medical judgment, advice, diagnosis, or treatment.
