# Socio-economic inequalities in the association between diabetes and labour force participation in Germany: A repeated cross-sectional study

## TL;DR

People with diabetes in Germany are less likely to work, and this effect is strongest among those with low socio-economic status.

## Contribution

This study quantifies how diabetes-related labor force participation gaps vary by socio-economic position in Germany.

## Key findings

- Labour force participation was 55.9% for people with diabetes versus 82.2% without diabetes.
- Labour force participation shortfall was greater for individuals with low socio-economic position.
- The association between diabetes and labor force participation varied by gender and socio-economic position.

## Abstract

Diabetes is associated with lower labour force participation. The proportion of people having diabetes is higher among people with a low socio-economic position. We aimed to describe socio-economic differences in the association between diabetes and labour force participation in Germany.

Based on repeated cross-sectional data from the German Socio-Economic Panel Study, the probability for participating in labour force was modelled with a logistic regression model including diabetes status, sex, socio-economic position, survey year and age as independent variables. Analyses accounted for the complex survey design of the study and used post-stratification weights. For easier interpretation, we estimated relative risks instead of odds ratios from logistic regression using post-estimation techniques. Relative labour force participation shortfall [%] was calculated as (1 – relative risk) x 100.

Labour force participation among people without diabetes was 82.2% compared to 55.9% among people with diabetes. Labour force participation shortfall was higher for low socio-economic position values and decreased with increasing socio-economic position. Labour force participation shortfall was generally larger among women while the association between labour force participation shortfall and socio-economic position was stronger among men.

Diabetes-associated labour force participation shortfall mainly affects people with low socio-economic position, which indicates that this population subgroup not only carries a higher risk of diabetes, but also might be more strongly affected by its negative impact on productivity. Future studies aiming to quantify diabetes-associated productivity losses should take associations specific to socio-economic position into account.