Measures

Participants answered the question “Has a doctor or other health professional ever told you that you have any of these conditions? Diabetes” to indicate if they have diabetes. Self-reported diabetes is a valid measure of diabetes status in various countries (39–45). However, the specific type of diabetes was not assessed in this sample.

Mental health was measured using the GHQ-12 (23). The GHQ-12 used the Likert method of scoring ranges from 0 (“Not at all”) to 3 (“Much more than usual”). A summary score across all the 12 items was used to represent general mental health. A higher score means worse mental health. For the purpose of the factor analysis, the GHQ-12 was scored from 1 (“Not at all”) to 4 (“Much more than usual”).

Demographic controls in the model include age (continuous), sex (male = 1 vs. female = 2), monthly income (continuous), highest educational qualification (college = 1 or below college = 2), legal marital status (single = 1 vs. married = 2), and residence (urban = 1 vs. rural = 2).