National Health Index shows an increase and marked regional differences in diabetes burden in Finland

BACKGROUND: The National Health Index contributes to the data bases needed for monitoring population health and development of health promotion policy and social and healthcare services. It includes a Morbidity Index and a Work Ability Index. The Morbidity Index is built on seven sub-indexes estimating the prevalence of the main components of the overall disease burden. The aim of this study is to describe the five-year time trend and regional differences in diabetes burden in Finland. METHODS: Diabetes index is based on four register data sources: (1) diagnosis in out-patient care, (ICD-codes), (2) hospital discharge diagnosis (ICD-codes), (3) purchase of diabetes medication (ATC-codes), and (4) special reimbursement for diabetes medication. Both non-standardized and age-standardized indexes were calculated. The time trend analysis is based on three three-year periods: 2017-2019, 2018-2020 and 2019-2021 for the whole country and separately for 22 regions. Index value 100 represents the average national level in the last period. RESULTS: National diabetes index increased from 94.9 in the first to 100 in the last follow-up period. The age-standardized values were 96,7 and 100, respectively. In 2019-2021 Åland region had the lowest index value (64.2) followed by Helsinki city (72.6). The highest index value (134.5) was observed in South Savo region. Age-standardization reduced the differences between regions which, nevertheless, remained remarkable: 63.2, 84.8 and 106.7, respectively. Furthermore, the highest age-standardized index value (117,5) was observed in South Ostrobothnia region. CONCLUSIONS: Diabetes burden is still increasing in Finland, and there are marked differences between regions. The increase and regional differences are partly explained by changes and differences in age-structure but also other (preventable) factors play an important role. In general, diabetes burden is highest in eastern and northern parts of the country. KEY MESSAGES: • Diabetes burden is still increasing in Finland, and there are marked differences between regions. • The increase and regional differences are partly explained by changes and differences in age-structure but also other (preventable) factors play an important role.