64-OR: Trends in Racial, Ethnic, and Socioeconomic Inequalities in Diagnosed Diabetes Prevalence and Incidence among U.S. Adults, 2008–2021

We examined national trends in racial, ethnic, and socioeconomic status (SES) inequalities for diagnosed diabetes prevalence and incidence. Self-reported data were from adults aged ≥18 years in the National Health Interview Survey 2008-2021. Annual prevalence and incidence estimates were age-standardized to the 2010 U.S. Census population. Absolute measures of inequality in diagnosed diabetes prevalence and incidence included between-group variance (BGV) for race and ethnicity (nominal categories) and the slope index of inequality (SII) for SES (educational attainment and family poverty-to-income ratio (PIR) ordinal categories). We calculated BGV and SII for each year along with the average annual percent change (AAPC) to assess trends in inequalities over time. PIR inequalities in diabetes prevalence increased (AAPC for SII: -1.7%, p=.010) while racial and ethnic (AAPC for BGV: -10.9%, p=.010) and education (AAPC for SII: 5.8%, p=.001) inequalities in diabetes incidence decreased over time (Figure). From 2008-2021, racial, ethnic, and education inequalities in diagnosed diabetes incidence improved but persisted. Income-related inequalities in diagnosed diabetes prevalence worsened over time. To close these gaps, future research could focus on identifying factors driving these trends including the contribution of morbidity and mortality.