Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race
The aims of this study are to confirm disparities in diabetes mortality rates based on race, determine if race predicts combinations of diabetes and multiple chronic conditions (MCC) that are leading causes of death (LCD), and determine if combinations of diabetes plus MCC mediate the relationship b...
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| Veröffentlicht in: | Diabetes research and clinical practice 2020-01, Vol.159, p.107984-107984, Article 107984 |
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| container_title | Diabetes research and clinical practice |
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| creator | Clements, John M. West, Brady T. Yaker, Zachary Lauinger, Breanna McCullers, Deven Haubert, James Tahboub, Mohammad Ali Everett, Gregory J. |
| description | The aims of this study are to confirm disparities in diabetes mortality rates based on race, determine if race predicts combinations of diabetes and multiple chronic conditions (MCC) that are leading causes of death (LCD), and determine if combinations of diabetes plus MCC mediate the relationship between race and mortality.
We performed a retrospective cohort study of 443,932 Medicare beneficiaries in the State of Michigan with type 2 diabetes mellitus and MCC. We applied Cox proportional hazards regression to determine predictors of mortality. We applied multinomial logistic regression to determine predictors of MCC combinations.
We found that race influences mortality in Medicare beneficiaries with Type 2 diabetes mellitus and MCC. Prior to adjusting for MCC combinations, we observed that Blacks and American Indian/Alaska Natives have increased risk of mortality compared to Whites, while there is no difference in mortality between Hispanics and Whites. Regarding MCC combinations, Black/African American beneficiaries experience increased odds for most MCC combinations while Asian/Pacific Islanders and Hispanics experience lower odds for MCC combinations, compared to Whites. When adjusting for MCC, mortality disparities observed between Whites, Black/African Americans, and American Indians/Alaska Natives persist.
Compared to Whites, Black/African Americans in our cohort had increased odds of most MCC combinations, and an increased risk of mortality that persisted even after adjusting for MCC combinations. |
| doi_str_mv | 10.1016/j.diabres.2019.107984 |
| format | Article |
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We performed a retrospective cohort study of 443,932 Medicare beneficiaries in the State of Michigan with type 2 diabetes mellitus and MCC. We applied Cox proportional hazards regression to determine predictors of mortality. We applied multinomial logistic regression to determine predictors of MCC combinations.
We found that race influences mortality in Medicare beneficiaries with Type 2 diabetes mellitus and MCC. Prior to adjusting for MCC combinations, we observed that Blacks and American Indian/Alaska Natives have increased risk of mortality compared to Whites, while there is no difference in mortality between Hispanics and Whites. Regarding MCC combinations, Black/African American beneficiaries experience increased odds for most MCC combinations while Asian/Pacific Islanders and Hispanics experience lower odds for MCC combinations, compared to Whites. When adjusting for MCC, mortality disparities observed between Whites, Black/African Americans, and American Indians/Alaska Natives persist.
Compared to Whites, Black/African Americans in our cohort had increased odds of most MCC combinations, and an increased risk of mortality that persisted even after adjusting for MCC combinations.</description><identifier>ISSN: 0168-8227</identifier><identifier>EISSN: 1872-8227</identifier><identifier>DOI: 10.1016/j.diabres.2019.107984</identifier><identifier>PMID: 31846667</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>African Americans - statistics & numerical data ; Aged ; Aged, 80 and over ; Cause of Death ; CHF ; CKD ; Cohort Studies ; Continental Population Groups - statistics & numerical data ; COPD ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - economics ; Diabetes Mellitus, Type 2 - ethnology ; Diabetes Mellitus, Type 2 - mortality ; Female ; Health Status Disparities ; Hispanic Americans - statistics & numerical data ; Humans ; Indians, North American - statistics & numerical data ; Male ; Medicare - statistics & numerical data ; Mortality ; Multiple Chronic Conditions - economics ; Multiple Chronic Conditions - epidemiology ; Multiple Chronic Conditions - ethnology ; Multiple Chronic Conditions - mortality ; Race ; Retrospective Studies ; Type 2 diabetes ; United States - epidemiology</subject><ispartof>Diabetes research and clinical practice, 2020-01, Vol.159, p.107984-107984, Article 107984</ispartof><rights>2019 Elsevier B.V.</rights><rights>Copyright © 2019 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c467t-7b6ba3a2306d60dc865d77b8f4add85973e58cb8a892e679889179e96d3e32dc3</citedby><cites>FETCH-LOGICAL-c467t-7b6ba3a2306d60dc865d77b8f4add85973e58cb8a892e679889179e96d3e32dc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0168822719308824$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,776,780,881,3536,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31846667$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Clements, John M.</creatorcontrib><creatorcontrib>West, Brady T.</creatorcontrib><creatorcontrib>Yaker, Zachary</creatorcontrib><creatorcontrib>Lauinger, Breanna</creatorcontrib><creatorcontrib>McCullers, Deven</creatorcontrib><creatorcontrib>Haubert, James</creatorcontrib><creatorcontrib>Tahboub, Mohammad Ali</creatorcontrib><creatorcontrib>Everett, Gregory J.</creatorcontrib><title>Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race</title><title>Diabetes research and clinical practice</title><addtitle>Diabetes Res Clin Pract</addtitle><description>The aims of this study are to confirm disparities in diabetes mortality rates based on race, determine if race predicts combinations of diabetes and multiple chronic conditions (MCC) that are leading causes of death (LCD), and determine if combinations of diabetes plus MCC mediate the relationship between race and mortality.
We performed a retrospective cohort study of 443,932 Medicare beneficiaries in the State of Michigan with type 2 diabetes mellitus and MCC. We applied Cox proportional hazards regression to determine predictors of mortality. We applied multinomial logistic regression to determine predictors of MCC combinations.
We found that race influences mortality in Medicare beneficiaries with Type 2 diabetes mellitus and MCC. Prior to adjusting for MCC combinations, we observed that Blacks and American Indian/Alaska Natives have increased risk of mortality compared to Whites, while there is no difference in mortality between Hispanics and Whites. Regarding MCC combinations, Black/African American beneficiaries experience increased odds for most MCC combinations while Asian/Pacific Islanders and Hispanics experience lower odds for MCC combinations, compared to Whites. When adjusting for MCC, mortality disparities observed between Whites, Black/African Americans, and American Indians/Alaska Natives persist.
Compared to Whites, Black/African Americans in our cohort had increased odds of most MCC combinations, and an increased risk of mortality that persisted even after adjusting for MCC combinations.</description><subject>African Americans - statistics & numerical data</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Cause of Death</subject><subject>CHF</subject><subject>CKD</subject><subject>Cohort Studies</subject><subject>Continental Population Groups - statistics & numerical data</subject><subject>COPD</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - economics</subject><subject>Diabetes Mellitus, Type 2 - ethnology</subject><subject>Diabetes Mellitus, Type 2 - mortality</subject><subject>Female</subject><subject>Health Status Disparities</subject><subject>Hispanic Americans - statistics & numerical data</subject><subject>Humans</subject><subject>Indians, North American - statistics & numerical data</subject><subject>Male</subject><subject>Medicare - statistics & numerical data</subject><subject>Mortality</subject><subject>Multiple Chronic Conditions - economics</subject><subject>Multiple Chronic Conditions - epidemiology</subject><subject>Multiple Chronic Conditions - ethnology</subject><subject>Multiple Chronic Conditions - mortality</subject><subject>Race</subject><subject>Retrospective Studies</subject><subject>Type 2 diabetes</subject><subject>United States - epidemiology</subject><issn>0168-8227</issn><issn>1872-8227</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1vEzEQhi0EoqHlJ4B85LLBH7v-4ABCpXxIlbi0Z-O1Z4mjjR1sb6X-e5wmVHDiNNbMM--M50XoFSVrSqh4u137YMcMZc0I1S0nteqfoBVVknWKMfkUrRqnHt5n6EUpW0KI4P3wHJ1xqnohhFyhH59C2dscaoCCQ8QHUahQugyzreDxbplr2M-A3SanGBx2KfqGp1iwja2ecrVzqPfv8M0GmsQ0LxAd4DThbB1coGeTnQu8PMVzdPv56ubya3f9_cu3y4_XneuFrJ0cxWi5ZZwIL4h3SgxeylFNvfVeDVpyGJQblVWagWh_VZpKDVp4Dpx5x8_R-6Pufhl34B3Emu1s9jnsbL43yQbzbyWGjfmZ7ozQg6asbwJvTgI5_VqgVLMLxcE82whpKYZxpvjAmFANHY6oy6mUDNPjGErMwR2zNSd3zMEdc3Sn9b3-e8fHrj92NODDEYB2qbsA2RQXDtf0IYOrxqfwnxG_AS8_peE</recordid><startdate>20200101</startdate><enddate>20200101</enddate><creator>Clements, John M.</creator><creator>West, Brady T.</creator><creator>Yaker, Zachary</creator><creator>Lauinger, Breanna</creator><creator>McCullers, Deven</creator><creator>Haubert, James</creator><creator>Tahboub, Mohammad Ali</creator><creator>Everett, Gregory J.</creator><general>Elsevier B.V</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>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200101</creationdate><title>Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race</title><author>Clements, John M. ; West, Brady T. ; Yaker, Zachary ; Lauinger, Breanna ; McCullers, Deven ; Haubert, James ; Tahboub, Mohammad Ali ; Everett, Gregory J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c467t-7b6ba3a2306d60dc865d77b8f4add85973e58cb8a892e679889179e96d3e32dc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>African Americans - statistics & numerical data</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Cause of Death</topic><topic>CHF</topic><topic>CKD</topic><topic>Cohort Studies</topic><topic>Continental Population Groups - statistics & numerical data</topic><topic>COPD</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - economics</topic><topic>Diabetes Mellitus, Type 2 - ethnology</topic><topic>Diabetes Mellitus, Type 2 - mortality</topic><topic>Female</topic><topic>Health Status Disparities</topic><topic>Hispanic Americans - statistics & numerical data</topic><topic>Humans</topic><topic>Indians, North American - statistics & numerical data</topic><topic>Male</topic><topic>Medicare - statistics & numerical data</topic><topic>Mortality</topic><topic>Multiple Chronic Conditions - economics</topic><topic>Multiple Chronic Conditions - epidemiology</topic><topic>Multiple Chronic Conditions - ethnology</topic><topic>Multiple Chronic Conditions - mortality</topic><topic>Race</topic><topic>Retrospective Studies</topic><topic>Type 2 diabetes</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Clements, John M.</creatorcontrib><creatorcontrib>West, Brady T.</creatorcontrib><creatorcontrib>Yaker, Zachary</creatorcontrib><creatorcontrib>Lauinger, Breanna</creatorcontrib><creatorcontrib>McCullers, Deven</creatorcontrib><creatorcontrib>Haubert, James</creatorcontrib><creatorcontrib>Tahboub, Mohammad Ali</creatorcontrib><creatorcontrib>Everett, Gregory J.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes research and clinical practice</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Clements, John M.</au><au>West, Brady T.</au><au>Yaker, Zachary</au><au>Lauinger, Breanna</au><au>McCullers, Deven</au><au>Haubert, James</au><au>Tahboub, Mohammad Ali</au><au>Everett, Gregory J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race</atitle><jtitle>Diabetes research and clinical practice</jtitle><addtitle>Diabetes Res Clin Pract</addtitle><date>2020-01-01</date><risdate>2020</risdate><volume>159</volume><spage>107984</spage><epage>107984</epage><pages>107984-107984</pages><artnum>107984</artnum><issn>0168-8227</issn><eissn>1872-8227</eissn><abstract>The aims of this study are to confirm disparities in diabetes mortality rates based on race, determine if race predicts combinations of diabetes and multiple chronic conditions (MCC) that are leading causes of death (LCD), and determine if combinations of diabetes plus MCC mediate the relationship between race and mortality.
We performed a retrospective cohort study of 443,932 Medicare beneficiaries in the State of Michigan with type 2 diabetes mellitus and MCC. We applied Cox proportional hazards regression to determine predictors of mortality. We applied multinomial logistic regression to determine predictors of MCC combinations.
We found that race influences mortality in Medicare beneficiaries with Type 2 diabetes mellitus and MCC. Prior to adjusting for MCC combinations, we observed that Blacks and American Indian/Alaska Natives have increased risk of mortality compared to Whites, while there is no difference in mortality between Hispanics and Whites. Regarding MCC combinations, Black/African American beneficiaries experience increased odds for most MCC combinations while Asian/Pacific Islanders and Hispanics experience lower odds for MCC combinations, compared to Whites. When adjusting for MCC, mortality disparities observed between Whites, Black/African Americans, and American Indians/Alaska Natives persist.
Compared to Whites, Black/African Americans in our cohort had increased odds of most MCC combinations, and an increased risk of mortality that persisted even after adjusting for MCC combinations.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>31846667</pmid><doi>10.1016/j.diabres.2019.107984</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes research and clinical practice, 2020-01, Vol.159, p.107984-107984, Article 107984 |
| issn | 0168-8227 1872-8227 |
| language | eng |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | African Americans - statistics & numerical data Aged Aged, 80 and over Cause of Death CHF CKD Cohort Studies Continental Population Groups - statistics & numerical data COPD Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - economics Diabetes Mellitus, Type 2 - ethnology Diabetes Mellitus, Type 2 - mortality Female Health Status Disparities Hispanic Americans - statistics & numerical data Humans Indians, North American - statistics & numerical data Male Medicare - statistics & numerical data Mortality Multiple Chronic Conditions - economics Multiple Chronic Conditions - epidemiology Multiple Chronic Conditions - ethnology Multiple Chronic Conditions - mortality Race Retrospective Studies Type 2 diabetes United States - epidemiology |
| title | Disparities in diabetes-related multiple chronic conditions and mortality: The influence of race |
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