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Epidemiology/Health Services/Psychosocial Research

Racial and Ethnic Differences in Health Care Access and Health Outcomes for Adults With Type 2 Diabetes

  1. Maureen I. Harris, PHD, MPH
  1. National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
    Diabetes Care 2001 Mar; 24(3): 454-459. https://doi.org/10.2337/diacare.24.3.454
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    Article Figures & Tables

    Tables

    • Table 1 —

      Characteristics of type 2 diabetic adults, according to race and ethnicity

      Non-Hispanic CaucasianNon-Hispanic African-AmericanMexican-American
      Median age (years)63.459.5*56.1†
      Median duration since diabetes diagnosis (years)6.47.65.4
      Men46.037.3‡38.7‡
      High school education or more61.142.7†23.1†
      Family income ≥$20,00058.631.5†35.0†
      Mean BMI (kg/m2)
       Men29.828.3*29.3
       Women30.832.6‡31.0
      Hypertension65.971.453.8‡
      Dyslipidemia65.362.251.2*
      • Data are %, unless otherwise indicated.

      • *

        ↵* P < 0.01

      • †

        ↵† P < 0.001

      • ‡

        ↵‡ P < 0.05 compared with non-Hispanic Caucasians.

    • Table 2 —

      Health care access for type 2 diabetic adults

      Health care accessNon-Hispanic CaucasianNon-Hispanic African-AmericanMexican-American
      One usual source of ambulatory medical care96.793.991.9
       Sees one primary physician at this source92.488.283.1
      Two or more physician visits in past 12 months90.386.683.2
      Health insurance
       Age 25–64 years91.488.765.9*
       Age ≥65 years99.8100.099.7
      Private health insurance
       Age 25–64 years80.862.9*46.2*
       Age ≥65 years80.342.9*40.9*
      Diabetes therapy
       Insulin25.741.6†25.3
       Oral agents45.736.5‡50.3
       Diet alone28.621.924.4
      Insulin treated, ≥2 injections per day60.442.3†48.2
      Self-monitors blood glucose at least once per day
       Not insulin-treated5.83.92.4
       Insulin-treated44.226.7†27.3†
      Eye examination in the past year65.370.160.8
      Blood pressure checked in the past 6 months88.489.483.4
      Cholesterol checked80.868.1*61.8*
      Hypertension
       Previously diagnosed, taking antihypertensive medication83.184.171.3‡
       Previously diagnosed, not taking antihypertension medication6.46.812.8‡
       Undiagnosed10.59.115.9
      Dyslipidemia
       Previously diagnosed, treated with diet or medication52.340.3‡40.6‡
       Previously diagnosed, not treated with diet or medication6.24.54.3
       Undiagnosed41.655.3‡55.1‡
      • Data are %. Sample sizes for hypertension (n = 864) and dyslipidemia (n = 627) exclude subjects who do not have these conditions; dyslipidemia data also exclude subjects with triglyceride levels ≥400 mg/dl for whom the Friedewald equation to compute LDL cholesterol is not valid.

      • *

        ↵* P < 0.001

      • †

        ↵† P < 0.01

      • ‡

        ↵‡ P < 0.05 compared with non-Hispanic Caucasians.

    • Table 3 —

      Health status and outcomes for type 2 diabetic adults

      Health care outcomeNon-Hispanic CaucasianNon-Hispanic African-AmericanMexican-American
      HbA1c ≥7.0%55.158.265.5*
      BMI ≥30 kg/m2
       Men43.534.337.0
       Women45.553.748.2
      Microalbuminuria29.627.326.3
      Clinical proteinuria5.213.6†11.2*
      Previously diagnosed hypertension
       Blood pressure <140/90 mmHg45.239.634.7
       Blood pressure ≥140/90 mmHg54.860.465.3
      Previously diagnosed dyslipidemia
       LDL cholesterol <130 mg/dl35.423.937.9
       LDL cholesterol ≥130 mg/dl64.676.162.1
      Serum total cholesterol (mg/dl)
       <20031.135.738.1
       200–23934.533.933.8
       ≥24034.430.428.1
      HDL cholesterol (mg/dl)
       <3528.913.0†20.1‡
       35–4532.728.033.9
       >4538.459.0†46.0‡
      Triglyceride (mg/dl)
       <20057.174.8†57.3
       200–39930.819.7*27.9
       ≥40012.15.5‡14.8
      LDL cholesterol (mg/dl)
       <10015.419.621.1‡
       100–12932.824.9‡36.4
       130–15930.628.626.6
       ≥16021.226.915.9
      Lipoprotein(a) >30 mg/dl20.158.8†21.3
      Homocysteine >15 μmol/l13.911.56.5‡
      Cigarette smoker18.023.917.7
      Hospitalized in past 12 months27.127.922.6
      • Data are %. The upper limit of normal for HbA1c in the assay system is 6.1%, defined as the mean + 2 SD (5.27 + 0.85%) for the group of people with fasting plasma glucose <110 mg/dl and 2-h postchallenge glucose <140 mg/dl. Samples sizes for previously diagnosed hypertension (n = 618) and previously diagnosed dyslipidemia (n = 302) exclude subjects who have not been diagnosed with these conditions; dyslipidemia data also exclude subjects with triglyceride levels ≥400 mg/dl for whom the Friedewald equation to compute LDL cholesterol is not valid.

      • *

        ↵* P < 0.01

      • †

        ↵† P < 0.001

      • ‡

        ↵‡ P < 0.05 compared with non-Hispanic Caucasians.

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    Diabetes Care: 24 (3)

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    Racial and Ethnic Differences in Health Care Access and Health Outcomes for Adults With Type 2 Diabetes
    Maureen I. Harris
    Diabetes Care Mar 2001, 24 (3) 454-459; DOI: 10.2337/diacare.24.3.454

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    Racial and Ethnic Differences in Health Care Access and Health Outcomes for Adults With Type 2 Diabetes
    Maureen I. Harris
    Diabetes Care Mar 2001, 24 (3) 454-459; DOI: 10.2337/diacare.24.3.454
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