Objective — Due in large part to effective pharmacotherapy, mortality rates have fallen substantially among those with diabetes; however, trends have been less favorable among those of lower socioeconomic status (SES), leading to a widening gap in mortality between rich and poor. The authors examined whether income disparities in diabetes-related morbidity or mortality decline after age 65, in a setting where much of health care is publicly funded yet universal drug coverage starts only at age 65.

Research Design & Methods — The authors conducted a population-based retrospective cohort study using administrative health claims from Ontario, Canada. Adults with diabetes (N = 606,051) were followed from 1 April 2002 to 31 March 2008 for a composite outcome of death, nonfatal acute myocardial infarction (AMI), and nonfatal stroke. SES was based on neighborhood median household income levels from the 2001 Canadian Census.

Results — SES was a strong predictor of death, nonfatal AMI, or nonfatal stroke among those