Racial and Ethnic Disparities in Diabetes Complications in the Northeastern United States: The Role of Socioeconomic Status
Abstract The role of socioeconomic status (SES) in explaining racial/ethnic disparities in diabetes remains unclear. We investigated disparities in self-reported diabetes complications and the role of macro (eg, income, education) and micro (eg, owning a home or having a checking account) SES indica...
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| Veröffentlicht in: | Journal of the National Medical Association 2013, Vol.105 (1), p.51-58 |
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| description | Abstract The role of socioeconomic status (SES) in explaining racial/ethnic disparities in diabetes remains unclear. We investigated disparities in self-reported diabetes complications and the role of macro (eg, income, education) and micro (eg, owning a home or having a checking account) SES indicators in explaining these differences. The sample included individuals with a diagnosis of diabetes (N = 795) who were aged, on average, 55 years, and 55.6% non-Hispanic white, 25.0% African American, and 19.4% Hispanic. Approximately 8% reported nephropathy, 35% reported retinopathy, and 16% reported cardiovascular disease. There were significant disparities in the rates of complications among non-Hispanic white, African American, and Hispanic participants, with Hispanic participants having the highest rates of nephropathy, retinopathy, and cardiovascular disease. Macro SES indicators (eg, income) mediated racial differences (ie, non-Hispanic whites vs African Americans) in self-reported retinopathy, a combination of macro and more micro SES indicators (eg, education, income, and owning a home or having a checking account) mediated racial/ethnic differences (ie, non-Hispanic white vs Hispanic participants) in self-reported cardiovascular disease, and only micro SES indicators (eg, owning a home or having a checking account) mediated differences between lower-income SES racial/ethnic minority groups (ie, African American vs Hispanic participants) in self-reported retinopathy and cardiovascular disease. Findings underscore that indicators of SES must be sensitive to the outcome of interest and the racial/ethnic groups being compared. |
| doi_str_mv | 10.1016/S0027-9684(15)30085-7 |
| format | Article |
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We investigated disparities in self-reported diabetes complications and the role of macro (eg, income, education) and micro (eg, owning a home or having a checking account) SES indicators in explaining these differences. The sample included individuals with a diagnosis of diabetes (N = 795) who were aged, on average, 55 years, and 55.6% non-Hispanic white, 25.0% African American, and 19.4% Hispanic. Approximately 8% reported nephropathy, 35% reported retinopathy, and 16% reported cardiovascular disease. There were significant disparities in the rates of complications among non-Hispanic white, African American, and Hispanic participants, with Hispanic participants having the highest rates of nephropathy, retinopathy, and cardiovascular disease. Macro SES indicators (eg, income) mediated racial differences (ie, non-Hispanic whites vs African Americans) in self-reported retinopathy, a combination of macro and more micro SES indicators (eg, education, income, and owning a home or having a checking account) mediated racial/ethnic differences (ie, non-Hispanic white vs Hispanic participants) in self-reported cardiovascular disease, and only micro SES indicators (eg, owning a home or having a checking account) mediated differences between lower-income SES racial/ethnic minority groups (ie, African American vs Hispanic participants) in self-reported retinopathy and cardiovascular disease. Findings underscore that indicators of SES must be sensitive to the outcome of interest and the racial/ethnic groups being compared.</description><identifier>ISSN: 0027-9684</identifier><identifier>EISSN: 1943-4693</identifier><identifier>DOI: 10.1016/S0027-9684(15)30085-7</identifier><identifier>PMID: 23862296</identifier><identifier>CODEN: JNMAAE</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>diabetes ; Diabetes Complications - ethnology ; Ethnic Groups ; Female ; health disparities ; Health Status Disparities ; Humans ; Internal Medicine ; Male ; Middle Aged ; minority health ; Morbidity - trends ; New England - epidemiology ; Retrospective Studies ; Risk Factors ; Social Class ; socioeconomic status</subject><ispartof>Journal of the National Medical Association, 2013, Vol.105 (1), p.51-58</ispartof><rights>National Medical Association</rights><rights>2013 National Medical Association</rights><rights>Copyright National Medical Association Spring 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c550t-f9eb5392b36eda821db73800fc7b4a97887fd69c0c1cb9009246a5465c4394b93</citedby><cites>FETCH-LOGICAL-c550t-f9eb5392b36eda821db73800fc7b4a97887fd69c0c1cb9009246a5465c4394b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23862296$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Osborn, Chandra Y., PhD, MPH</creatorcontrib><creatorcontrib>Groot, Mary de, PhD</creatorcontrib><creatorcontrib>Wagner, Julie A., PhD</creatorcontrib><title>Racial and Ethnic Disparities in Diabetes Complications in the Northeastern United States: The Role of Socioeconomic Status</title><title>Journal of the National Medical Association</title><addtitle>J Natl Med Assoc</addtitle><description>Abstract The role of socioeconomic status (SES) in explaining racial/ethnic disparities in diabetes remains unclear. We investigated disparities in self-reported diabetes complications and the role of macro (eg, income, education) and micro (eg, owning a home or having a checking account) SES indicators in explaining these differences. The sample included individuals with a diagnosis of diabetes (N = 795) who were aged, on average, 55 years, and 55.6% non-Hispanic white, 25.0% African American, and 19.4% Hispanic. Approximately 8% reported nephropathy, 35% reported retinopathy, and 16% reported cardiovascular disease. There were significant disparities in the rates of complications among non-Hispanic white, African American, and Hispanic participants, with Hispanic participants having the highest rates of nephropathy, retinopathy, and cardiovascular disease. Macro SES indicators (eg, income) mediated racial differences (ie, non-Hispanic whites vs African Americans) in self-reported retinopathy, a combination of macro and more micro SES indicators (eg, education, income, and owning a home or having a checking account) mediated racial/ethnic differences (ie, non-Hispanic white vs Hispanic participants) in self-reported cardiovascular disease, and only micro SES indicators (eg, owning a home or having a checking account) mediated differences between lower-income SES racial/ethnic minority groups (ie, African American vs Hispanic participants) in self-reported retinopathy and cardiovascular disease. Findings underscore that indicators of SES must be sensitive to the outcome of interest and the racial/ethnic groups being compared.</description><subject>diabetes</subject><subject>Diabetes Complications - ethnology</subject><subject>Ethnic Groups</subject><subject>Female</subject><subject>health disparities</subject><subject>Health Status Disparities</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Middle Aged</subject><subject>minority health</subject><subject>Morbidity - trends</subject><subject>New England - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Social Class</subject><subject>socioeconomic status</subject><issn>0027-9684</issn><issn>1943-4693</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkk1v1DAQhiMEokvhJ4AscSmHgB3Hjs2hCG3Lh1SB1G3PluNMWJfE3tpOpap_Hme3LNALp7E1z7wz49dF8ZLgtwQT_m6FcdWUkov6iLA3FGPByuZRsSCypmXNJX1cLPbIQfEsxiucIcnY0-KgooJXleSL4u5cG6sHpF2HTtPaWYNObNzoYJOFiKzLV91CyuelHzeDNTpZ77aZtAb0zYccdEwQHLp0NkGHVkln_j26yPlzPwDyPVp5Yz0Y7_yYW8zEFJ8XT3o9RHhxHw-Ly0-nF8sv5dn3z1-XH89KwxhOZS-hZVRWLeXQaVGRrm2owLg3TVtr2QjR9B2XBhtiWomxrGquWc2ZqamsW0kPi-Od7mZqR-gMuBT0oDbBjjrcKq-t-jfj7Fr98DeKClZxwbPA0b1A8NcTxKRGGw0Mg3bgp6hIjTlpOBMso68foFd-Ci6vlykiKik5mSdiO8oEH2OAfj8MwWq2V23tVbN3ijC1tVc1ue7V35vsq377mYEPOwDye95YCCoaC85AZwOYpDpv_9vi-IGCGWz-Fnr4CbcQ_2yjYqXwTmTWIGyr0NBf_W_Kzg</recordid><startdate>2013</startdate><enddate>2013</enddate><creator>Osborn, Chandra Y., PhD, MPH</creator><creator>Groot, Mary de, PhD</creator><creator>Wagner, Julie A., PhD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>4U-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2013</creationdate><title>Racial and Ethnic Disparities in Diabetes Complications in the Northeastern United States: The Role of Socioeconomic Status</title><author>Osborn, Chandra Y., PhD, MPH ; 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We investigated disparities in self-reported diabetes complications and the role of macro (eg, income, education) and micro (eg, owning a home or having a checking account) SES indicators in explaining these differences. The sample included individuals with a diagnosis of diabetes (N = 795) who were aged, on average, 55 years, and 55.6% non-Hispanic white, 25.0% African American, and 19.4% Hispanic. Approximately 8% reported nephropathy, 35% reported retinopathy, and 16% reported cardiovascular disease. There were significant disparities in the rates of complications among non-Hispanic white, African American, and Hispanic participants, with Hispanic participants having the highest rates of nephropathy, retinopathy, and cardiovascular disease. Macro SES indicators (eg, income) mediated racial differences (ie, non-Hispanic whites vs African Americans) in self-reported retinopathy, a combination of macro and more micro SES indicators (eg, education, income, and owning a home or having a checking account) mediated racial/ethnic differences (ie, non-Hispanic white vs Hispanic participants) in self-reported cardiovascular disease, and only micro SES indicators (eg, owning a home or having a checking account) mediated differences between lower-income SES racial/ethnic minority groups (ie, African American vs Hispanic participants) in self-reported retinopathy and cardiovascular disease. Findings underscore that indicators of SES must be sensitive to the outcome of interest and the racial/ethnic groups being compared.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>23862296</pmid><doi>10.1016/S0027-9684(15)30085-7</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | diabetes Diabetes Complications - ethnology Ethnic Groups Female health disparities Health Status Disparities Humans Internal Medicine Male Middle Aged minority health Morbidity - trends New England - epidemiology Retrospective Studies Risk Factors Social Class socioeconomic status |
| title | Racial and Ethnic Disparities in Diabetes Complications in the Northeastern United States: The Role of Socioeconomic Status |
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