Abstract
BackgroundDespite the large body of research on racial/ethnic disparities in health, there are limited data on health disparities in Caribbean origin populations. This review aims to analyze and synthesize published literature on the disparities in diabetes mellitus (DM) and its complications among Afro-Caribbean populations.MethodsA detailed protocol, including a comprehensive search strategy, was developed and used to identify potentially relevant studies. Identified studies were then screened for eligibility using pre-specified inclusion and exclusion criteria. An extraction form was developed to chart data and collate study characteristics including methods and main findings. Charted information was tagged by disparity indicators and thematic analysis performed. Disparity indicators evaluated include ethnicity, sex, age, socioeconomic status, disability and geographic location. Gaps in the literature were identified and extrapolated into a gap map.ResultsA total of 1009 diabetes related articles/manuscripts, published between 1972 and 2013, were identified and screened. Forty-three studies met inclusion criteria for detailed analysis. Most studies were conducted in the United Kingdom, Trinidad and Tobago and Jamaica, and used a cross-sectional study design. Overall, studies reported a higher prevalence of DM among Caribbean Blacks compared to West African Blacks and Caucasians but lower when compared to South Asian origin groups. Morbidity from diabetes-related complications was highest in persons with low socioeconomic status. Gap analysis showed limited research data reporting diabetes incidence by sex and socioeconomic status. No published literature was found on disability status or sexual orientation as it relates to diabetes burden or complications. Prevalence and morbidity were the most frequently reported outcomes.ConclusionLiterature on diabetes health disparities in Caribbean origin populations is limited. Future research should address these knowledge gaps and develop approaches to reduce them.
Highlights
In 1995, the global prevalence of diabetes mellitus (DM) in adults was estimated to be 4.0% and projected to rise to 5.4% by the year 2025 [1]
Inclusion criteria Studies that reported on diabetes mellitus and the effect which health disparities had on Caribbean populations were examined
Prevalence and incidence of diabetes in Afro-Caribbean populations Seventeen papers reported on the prevalence of diabetes mellitus by ethnicity [15,16,18,20,22,23,25,31,32,38,4042,47,49-51] Overall, the prevalence of diabetes was higher among Afro-Caribbean populations when compared to other African ethnic groups [25,41,42], except in one study where the prevalence among Black Africans (11%) was higher in comparison to Afro-Caribbean (7%) (Table 2) [23]
Summary
In 1995, the global prevalence of diabetes mellitus (DM) in adults was estimated to be 4.0% and projected to rise to 5.4% by the year 2025 [1]. By 2011, the International Diabetes Federation (IDF) estimated the global prevalence of diabetes mellitus to be 8.3% and projected a rise to 9.9% by 2030. In absolute numbers, this translates to 366 million persons with diabetes mellitus in 2011 which will rise to 552 million people by. This review aims to analyze and synthesize published literature on the disparities in diabetes mellitus (DM) and its complications among Afro-Caribbean populations
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