Abstract

Objective: 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 (MEPS), we report estimates for: receipt of a cholesterol test; routine checkup; influenza vaccination; eye exam; dental checkup; foot exam; and having two or more A1C tests in a year for foreign- (n=1,272) and U.S.-born (n=5,811) individuals 18 years of age and older. We define a dichotomous variable representing full compliance with the above exams. We provide descriptive characteristics of the sample and use multivariable analysis for each procedure using random effects logit regression.

Results: Compared to U.S.-born individuals with diabetes, foreign-born are younger, have lower education levels and income, are more likely to have public or no insurance, and less likely to have a usual source of care. Adjusting for all potential confounders, foreign-born individuals were less likely to report having had an influenza vaccination (OR = 0.51; 95% CI = 0.31, 0.71) or to be compliant with any one of the seven recommendations (OR = 0.64; 95% CI = 0.34, 0.95).

Conclusions: These findings demonstrate that immigrants are less likely than U.S. born persons with diabetes to adhere to any one of seven diabetes care recommendations in general, and specifically are less likely to report having received influenza vaccination. Because immigrants are less likely to utilize health care, clinicians should take advantage of the office visit to effectively communicate with the patient the importance of receiving an influenza vaccination.