Quality of Diabetes Care for Immigrants in the U.S.
- Florence J. Dallo, PHD, MPH1,
- Fernando A. Wilson, PHD2 and
- Jim P. Stimpson, PHD3
- 1School of Health Sciences, Oakland University, Rochester, Michigan;
- 2Department of Health Management and Policy, School of Public Health, University of North Texas Health Science Center, Fort Worth, Texas;
- 3Department of Social and Behavioral Sciences, University of North Texas Health Science Center, Fort Worth, Texas.
- Corresponding author: Florence J. Dallo, flora.dallo{at}utsouthwestern.edu.
Abstract
OBJECTIVE To compare achievement of the American Diabetes Association diabetes care recommendations for U.S.- and foreign-born individuals with diabetes.
RESEARCH DESIGN AND METHODS Using the 2001–2006 Medical Expenditure Panel Surveys, we report estimates for receipt of a cholesterol test, routine checkup, influenza vaccination, eye examination, dental checkup, foot examination, and two or more A1C tests in 1 year for foreign- (n = 1,272) and U.S.-born (n = 5,811) individuals aged ≥18 years. We define a dichotomous variable representing full compliance with the above examinations. We provide descriptive characteristics of the sample and use multivariable analysis for each procedure with random effects logit regression.
RESULTS Compared with U.S.-born individuals with diabetes, foreign-born individuals are younger, have lower education levels and income, are more likely to have public or no insurance, and are less likely to have a usual source of care. With adjustment for all potential confounders, foreign-born individuals are less likely to report having had an influenza vaccination (odds ratio 0.51 [95% CI 0.31–0.71]) or to be compliant with any one of the seven recommendations (0.64 [0.34–0.95]).
CONCLUSIONS These findings demonstrate that immigrants are less likely than U.S.-born individuals with diabetes to adhere to any one of seven diabetes care recommendations in general and, specifically, are less likely to report having received an influenza vaccination. Because immigrants are less likely to use health care, clinicians should take advantage of the office visit to effectively communicate to the patient the importance of receiving an influenza vaccination.
Footnotes
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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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- Received February 11, 2009.
- Accepted May 13, 2009.
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Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.
- © 2009 by the American Diabetes Association.
