Diabetes and employment productivity: Does diabetes management matter?

H. Shelton Brown, Adriana Peŕez, Lisa Marie Yarnell, José A. Pagán, Craig L. Hanis, Susan P. Fisher-Hoch, Joseph B. McCormick

Research output: Contribution to journalArticlepeer-review


Objective: To determine whether labor market effects were the result of diabetes per se or rather depended on the degree to which diabetes was controlled through management of blood sugar levels. Methods: This study utilized data from a recently completed survey of households in Brownsville, Texas, a largely Mexican American community with a high prevalence of diabetes that is located on the Texas-Mexico border. Diabetes management, or control, was measured by blood sugar levels, glycosylated hemoglobin (A1C) levels, and interaction terms. Methods used were probit and Heckman regression. Results: Management of diabetes did not appear to have a discernible impact on labor market outcomes in the short run. However, diabetes was negatively associated with male productivity, particularly in males' propensity to work. The new American Diabetes Association (ADA) definition of diabetes is based on having an A1C level of <6.5%. Using the new ADA definition, diabetes was negatively associated with female productivity. Female productivity was also negatively associated with the new ADA definition of prediabetes (A1C levels between 5.7% and 6.4%). However, very few people with diabetes actually controlled their blood sugar or A1C levels. Conclusion: These results imply that in order to avoid productivity losses associated with diabetes, more scarce prevention resources should be spent on prevention of the onset of diabetes than on the management of A1C for those already diagnosed with diabetes. For women, the prevention of prediabetes is key.

Original languageEnglish (US)
Pages (from-to)569-576
Number of pages8
JournalAmerican Journal of Managed Care
Issue number8
StatePublished - Aug 2011

ASJC Scopus subject areas

  • Health Policy


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