Over the past three decades, remarkable advancements in medical technology have significantly improved the detection and treatment of diabetes, enhancing the health of those affected. However, a recent study from the USC Schaeffer Center published in JAMA Health Forum reveals an unexpected trend: despite these health improvements, workforce participation among individuals with diabetes has not increased over time. This phenomenon, termed the "diabetes paradox," highlights a growing concern for labor markets and government disability programs as diabetes prevalence continues to rise.

The "diabetes paradox" is a complex issue influenced by various factors such as evolving demographics, disparities in accessing medical innovations, and changes in the nature of work. Researchers analyzed two decades of data from the National Health Interview Survey (1998-2018) involving nearly 250,000 Americans aged 40-64, a period coinciding with peak earning years and frequent diabetes diagnoses. Despite significant health progress, individuals with diabetes were consistently less likely to participate in the labor force compared to their peers without the condition. Additionally, they were more prone to claiming disability benefits, even after adjusting for demographic differences.

One possible explanation lies in the changing profile of those diagnosed with diabetes. Improved healthcare access may have led to more diagnoses among economically disadvantaged groups who previously went undiagnosed. For instance, the expansion of Medicaid under the Affordable Care Act a decade ago contributed to an increase in diabetes diagnoses among low-income adults. Those with fewer resources might benefit less from advancements in diabetes prevention, widening the gap in educational attainment between people with diabetes and the general population. Furthermore, physically demanding jobs, often sought by individuals with lower education levels, make it challenging for them to remain employed after a diabetes diagnosis.

Interestingly, the study noted a slight increase in employment among people with diabetes during the COVID-19 pandemic, suggesting that work-from-home policies may have positively impacted their employment prospects. While the findings indicate stable economic outcomes for this group, researchers speculate that underlying conditions might be improving. Matthew Kahn, a senior scholar at the Schaeffer Center, suggests that expanded healthcare access for the poor and proactive measures taken by those diagnosed with pre-diabetes could mean that newly diagnosed individuals are more economically vulnerable than in previous decades.

To address the challenges posed by the diabetes paradox, researchers advocate for clinical trials on diabetes prevention and management therapies to incorporate assessments of economic outcomes like employment. Such evaluations could provide valuable insights into enhancing workforce participation among individuals with diabetes, ultimately benefiting both the labor market and public health initiatives.