Racial and Ethnic Variation in Access to Health Care, Provision of Health Care Services, and Ratings of Health Among Women With Histories of Gestational Diabetes Mellitus
- Catherine Kim, MD, MPH1,
- Brandy Sinco, MS2 and
- Edith A. Kieffer, MPH, PHD2
- 1Departments of Medicine and Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan
- 2School of Social Work, University of Michigan, Ann Arbor, Michigan
- Address correspondence and reprint requests to Catherine Kim, MD, MPH, 300 NIB, Room 7C13, Box 0429, Ann Arbor, MI 48109. E-mail: cathkim{at}umich.edu
Abstract
OBJECTIVE—The purpose of this study was to assess racial/ethnic variation in access to health care, use of particular health care services, presence of cardiovascular risk factors, and perceptions of health and impairment among women at risk for type 2 diabetes because of their histories of gestational diabetes mellitus (hGDM).
RESEARCH DESIGN AND METHODS—We performed a cross-sectional study using the 2001–2003 Behavioral Risk Factor Surveillance System, a national population-based, random sample telephone survey. We assessed access to health care, use of family planning, measurement and elevation of cholesterol, elevation of blood pressure, and respondents’ perceptions of health and impairment among women aged 18–44 years with hGDM (n = 4,718). Multivariate models adjusted for sociodemographic characteristics, BMI, presence of children in the household, and current smoking.
RESULTS—Outcome measures were suboptimal across racial/ethnic groups. Approximately one-fifth of the overall population reported no health insurance, cost barriers to physician visits, and no primary care provider. One-quarter had no examination within the past year, and almost one-fifth reported no family planning and elevated cholesterol levels. Latinas were the most disadvantaged, with 40% reporting no health insurance and no primary care provider and one-fourth reporting suboptimal perceptions of health. Asian/Pacific Islanders were the most advantaged in terms of health care access, cholesterol and blood pressure elevation, and impaired physical health. Racial/ethnic differences in health care use and presence of risk factors were not entirely explained by health care access or other covariates.
CONCLUSIONS—Significant racial/ethnic variation exists among women with hGDM for access to and use of health care, presence of risk factors, and perceptions of health.
- A/PI, Asian/Pacific Islander
- BRFSS, Behavioral Risk Factor Surveillance System Survey
- hGDM, history of gestational diabetes mellitus
- NA/AN, Native American/Native Alaskan
- NHW, non-Hispanic white
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 15 March 2007. DOI: 10.2337/dc06-2523.
A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances.
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.
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- Accepted March 4, 2007.
- Received December 13, 2006.
- DIABETES CARE
