Are racial/ethnic minorities recently diagnosed with diabetes less likely than white individuals to receive guideline-directed diabetes preventive care?

• Published in: BMC health services research Vol. 21; no. 1; p. 1150
• Main Authors: Marcondes, Felippe O, Cheng, David, Alegria, Margarita, Haas, Jennifer S
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 25-10-2021; BioMed Central; BMC
• Subjects: African Americans; Age; Black or African American; Blood pressure; Body mass index; Cholesterol; Cultural differences; Diabetes; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diabetes Mellitus - prevention & control; Diabetes therapy; Discrimination in medical care; Disease prevention; Disparities; Ethnicity; Eye examinations; Family income; Health aspects; Health care disparities; Health insurance; Health services; Hispanic Americans; Hispanic or Latino; Hispanic people; Humans; Hypertension; Insurance coverage; Marital status; Medical diagnosis; Medicine, Preventive; Population; Prevention; Preventive health services; Race; race/ethnicity; Sensitivity analysis; Social aspects; Social Class; Socioeconomic factors; United States - epidemiology; White people; United States; United States > US; Prevention; Disparities; Diabetes; race/ethnicity
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-021-07146-0

Diabetes mellitus has reached epidemic proportions in the United States. As the prevalence of diabetes continues to rise, the burden of disease is divided unevenly among different populations. Racial/ethnic disparities in diabetes care are pervasive, including the provision of care for prevention of complications. Prevention efforts should be focused on the time that immediately follows a diagnosis of diabetes. The aim of this study was to assess racial/ethnic differences in the receipt of guideline-directed diabetes care for complication prevention by individuals recently diagnosed with diabetes.
We used repeated cross-sections of individuals recently diagnosed with diabetes (within the past 5 years) from the National Health Interview Survey from 2011 to 2017. Multivariate regression was used to estimate the associations between race/ethnicity (non-Hispanic White, non-Hispanic Black and Hispanic) and guideline-directed process measures for prevention of diabetes complications (visits to an eye and foot specialist, and blood pressure and cholesterol checks by a health professional - each in the prior year). We assessed effect modification of these associations by socioeconomic status (SES).
In a sample of 7,341 participants, Hispanics had lower rates of having any insurance coverage (75.9 %) than Non-Hispanic Whites (93.2 %) and Blacks (88.1 %; p<0.001). After adjustment for demographics, total comorbidities, SES, and health insurance status, Hispanics were less likely to have an eye exam in the prior year (OR 0.80; (95 % CI 0.65-0.99); p=0.04) and a blood pressure check (OR 0.42; (95 % CI 0.28-0.65); p<0.001) compared to Non-Hispanic Whites. There was no significant effect modification of race/ethnicity by SES.
Hispanics recently diagnosed with diabetes were less likely to receive some indicators of guideline-directed care for the prevention of complications. Lack of insurance and SES may partially explain those differences. Future work should consider policy change and providers' behaviors linked to racial/ethnic disparities in diabetes care.