Assessing Diabetes and Factors Associated with Foregoing Medical Care among Persons with Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in the U.S. (2011-2015)

• Published in: International journal of environmental research and public health Vol. 14; no. 5; p. 464
• Main Authors: Towne, Samuel D, Bolin, Jane, Ferdinand, Alva, Nicklett, Emily Joy, Smith, Matthew Lee, Ory, Marcia G
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 26.04.2017; MDPI
• Subjects: Adults; Behavioral Risk Factor Surveillance System; Chronic illnesses; Colleges & universities; Complications; Diabetes mellitus; Diabetes Mellitus - epidemiology; Diabetes Mellitus - prevention & control; Diabetes Mellitus - psychology; Diagnosis; Disease control; Education; Health care; Health care policy; Health services; Minority & ethnic groups; Native North Americans; Patient Acceptance of Health Care - psychology; Patient Acceptance of Health Care - statistics & numerical data; Prevalence; Risk Factors; Risk groups; Risk taking; Rural areas; Socioeconomic Factors; Surveillance; United States - epidemiology; United States > US; Alaska; environmental and social predictors; place-based disparities; health disparities
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph14050464

: Identify individual- and place-based factors associated with diagnosed diabetes and forgone medical care among those diagnosed with diabetes. : Diabetes affects millions of individuals globally. In the U.S. alone the prevalence rate of diagnosed diabetes has more than doubled over the past 20 years (4.2% in 1994 to 10% in 2014). : The Behavioral Risk Factor Surveillance System (2011-2015) was used to identify factors associated with self-reported diabetes diagnoses (ever diagnosed) among U.S. adults. Logistic regression modeled: (1) the likelihood of having diabetes; (2) the likelihood of forgone medical care among those with diabetes, given appropriate medical care has been linked to preventing complications associated with diabetes. : Rates of diabetes remained relatively stable from 2011 to 2015. The likelihood of diabetes was higher ( < 0.01) among racial and ethnic minority groups, men, those with lower incomes and those with lower education. Place-based disparities indicating a higher likelihood of having a diagnosis of diabetes were found for those living in rural areas (urban versus rural, unadjusted OR = 0.844-0.908; < 0.01) and those living in the South (North, Midwest, and Western/Pacific regions versus the South, unadjusted OR = 0.794-0.889; < 0.01). Similar results were found with forgone medical care among those diagnosed with diabetes being more likely in the South (North, Midwest, and Western/Pacific regions versus the South, unadjusted OR = 0.542-0.819). In fully-adjusted analyses, the prevalence of diabetes and forgone medical care among those diagnosed with diabetes was higher for those with lower incomes, from several racial/ethnic minority groups, and in the South versus most other regions. : Identifying at-risk groups informs targets for prevention and assists efforts to address chronic disease self-management among those already diagnosed with diabetes.