Diabetes: A Global Challenge With High Economic Burden for Public Health Systems and Society

The rapid growth of diabetes in older adults represents a global event with broad challenges for public health systems at a world level. As explained in Caspersen et al.,1 diabetes and its complications are a great economic challenge for any health system, particularly when the disease is present in older adults. This is because of the high prevalence of complications in older adults in any society. Because diabetes represents an economic burden, the financial pressure that it places on public health systems might cause these systems to collapse. In this sense, the policy proposal to broaden public health systems and make them more effective is an urgent one for the globe and cannot be deferred. In middle-income countries and in the United States, we face a global problem that is generating high catastrophic expenditures for all those involved. For example, in Mexico, a 2011 study, which followed the same methodology of a project study conducted in 2004,2 was conducted to identify the costs generated by diabetes in older adults. The results indicated not only the high impact of costs on public health systems but also on patients’ pockets. Indeed, the demand for older adult health care goes beyond the capacity of the public health system, and patients end up financing most of the care for their diabetes and its complications.3 As shown in Table 1, out of every $100 spent on health in Mexico in 2011, patients contributed $52 and the public health system contributed $48. This evidence has important implications in terms of equity and access to public health programs. Actually, there is a need to reformulate policies and programs for diabetes in older adults by emphasizing greater investments in public health actions for promotion and prevention. This is based on evidence of the economic burden that diabetes represents. It is a public health priority both for the health system and for society as a whole. By reprioritizing, patients’ catastrophic expenditures will decrease and, above all, the high costs of temporary disability, permanent disability, and premature death generated by diabetes in older adults will diminish.