Diabetes affects drop out rate, lifetime earnings

Diabetes is contributing to high school dropout rates and reducing lifetime earnings for young people, according to a new study published Monday in the journal Health Affairs.

Researchers found the high school dropout rate among diabetics was 6% higher than the dropout rate among their peers.  They also found the likelihood that a diabetic student will attend college is 8 to 13% lower and that over the course of a lifetime, a diabetic could lose more than $160,000 in wages.

About 15,000 people were followed during the 14-year study.  Seven to 12-year old students were first surveyed in the mid-1990s. They were then surveyed three more times: 1 year later, 7 years later and the last time in 2008, when they were approaching age 30. The study did not distinguish between type 1, commonly referred to as juvenile diabetes, and the preventable type 2 diabetes, which is usually linked to obesity and sedentary lifestyles.

Declines were seen in education, employment and earnings for diabetics diagnosed as teenagers and young adults.  Researchers believe that 5,000 high school students drop out as a result of the chronic disease each year.

"One of our most important findings was the large increases in high school drop outs associated with growing up with diabetes versus not," said Jason Fletcher, lead author and an associate professor with the Division of Health Policy and Administration at Yale's School of Public Health. "This just points to the early effects of diabetes. It's a very severe consequence and it happens early - 17, 18 year olds who are dropping out of high school and they have a whole life of consequences associated with that [action]."

Those consequences, Fletcher says, can be reflected in lower wages over their working life. The study found that a diabetic earning an average income of $35,000 a year can expect to lose about $4,000 to $6,000 annually, totaling about $160,000 over their lifetime. One reason, researchers say, is because diabetics have much higher rates of absence from work (and school).

"Individuals with diabetes are less likely to be working at age 30 and for those who are working, when we compare them to similar individuals without diabetes, then they are also earning less money each year. Employers look at individuals that are expected to have high medical costs and offer them lower wages or lower salaries."

The study also found that there were inter-generational outcomes associated with the disease. For example, having a parent with diabetes reduced the chances a diabetic teen or young adult would attend college by 4 to 6%. And having a father with the disease lowered the likelihood of employment at age 30 by 7%.

"When we think about consequences of diabetes as a chronic illness we should think about both the medical costs and the non-medical costs," Fletcher said. "We found very large differences between individuals with diabetes and individuals without diabetes. These effects are happening early in people's lives, so this just suggests that we need to redirect some of our focus to earlier ages when we think about screening and public policy."

Another diabetes study in Health Affairs found that the numbers aren't going down. If the trend continues, up to 40 million adults could have diabetes and 100 million could be diagnosed as pre-diabetics over the next 10 years.

"The epidemic of pre-diabetes and diabetes is the greatest health challenge of the 21st century, bar none," says study author Dr. Deneen Vojta, chief clinical office for the UnitedHealth Diabetes Prevention and Control Alliance. "Today we have about 28 million living with diabetes and 80 million living with pre-diabetes. This is not an overnight problem. It's going to take a national effort to stem this epidemic. If we do nothing we can anticipate that 80 million going to 100 million in 10 years... That's 50% of the population that will be diabetic or pre-diabetic by 2021."

According to the American Diabetes Association about 26 million Americans have diabetes. Seven million of those have never been officially diagnosed.  It says the report shows the significant barriers diabetics face at school and work.

"One barrier many workers with diabetes face are employers who do not understand diabetes and have stereotyped views about the difficulty of managing diabetes and the potential work-related safety risks, and thus deny employment opportunities based on outdated qualifications standards that are not medically sound," the ADA told CNN. "The Association has worked to educate schools and employers in order to prevent discrimination based on diabetes and to help people with diabetes protect their rights when discrimination occurs."