Association of Poverty Income Ratio on the Effect of Peripheral Neuropathy on Overall Mortality in a Non-Diabetic Adult Population

Peripheral neuropathy (PN) is a disorder of the peripheral nervous system associated with significant morbidity and mortality. PN is common among U.S. adults, even in the absence of diabetes, where it presents with sensory symptoms such as tingling, numbness, burning, pain, and sensory ataxia. Motor symptoms include muscle cramps, stiffness, weakness, and wasting. The overall prevalence of PN in the United States is 13.5% in adults with diabetes and 11.6% in adults without diabetes, clearly indicating that PN is a significant public health problem among U.S. adults. Poverty and low income have been associated with poor health outcomes. There are no published studies examining whether poverty income ratio is associated with the effect of PN on overall mortality among U.S. adults without diabetes. Using the socioecological model as the theoretical framework, the purpose of this longitudinal study was to examine whether poverty income ratio moderated the effect of PN on overall mortality. Secondary data from the National Health and Nutrition Examination Survey (NHANES) 1999-2015 dataset were analyzed using complex sample Cox regression analysis with the threshold for statistical significance taken at p p p < 0.05). Participants without diabetes but who were poorer (with a reduced poverty income ratio of 0 - 1.99), had an increased hazard for overall mortality when diagnosed with PN in the left foot. This study is significant in its implications for positive social change. The results can enable relevant stakeholders to institute policies to reduce income inequality, promote gainful employment, and institute appropriate targeted screening for PN among U.S. adults without diabetes who are poor and of lower income.