Abstract
Background. The mortality and prevalence of diabetes mellitus (DM) vary across racial/ethnic groups with African Americans/blacks being disproportionately affected. However, it is unclear to what extent such disparities persist after the adjustment for covariates related to race/ethnicity and/or DM in the population. We aimed to assess racial/ethnic disparities in DM and to determine which covariates account for the observed racial/ethnic variabilities. Materials and Methods. We utilized a large cross-sectional survey of the US noninstitutionalized residents (n=30,852) to investigate the racial/ethnic disparities in diabetes mellitus, and the degree in which the disparities are explained by the relevant covariates. Pearson’s chi-square was used to examine study variables by race/ethnicity, while logistic regression was used to assess the effect of race/ethnicity and other covariates on DM prevalence. Results. There were statistically significant ethnic/racial differences with respect to income, education, marital status, smoking, alcohol, physical activities, body mass index, and age, P<0.05, but not insurance coverage, P>0.05. Race/ethnicity was a single independent predictor of DM, with African Americans (non-Hispanic blacks) more likely to be diagnosed for DM compared with non-Hispanic whites, prevalence odds ratio (POR) 1.45, 95% confidence interval (CI) 1.30–1.62, while Hispanics were less likely to be diagnosed, POR = 0.98, 95% CI 0.87–1.09. Similarly, after controlling for potential confounders, the racial/ethnic variability in DM between AA/blacks and non-Hispanic whites persisted, adjusted POR = 1.30, 95% CI 1.15–1.47. Conclusions. Racial/ethnic variability exists in DM prevalence and is unexplained by racial/ethnic variance in education, income, marital status, smoking, alcohol, physical activities, age, and sex.
Highlights
Diabetes mellitus (DM) is one of the leading causes of death and disability in the United States, placing a significant public health burden both on individuals with diabetes mellitus (DM) as well as on the US health care system [1,2,3,4,5,6]
Race/ethnicity was a single independent predictor of DM, with African Americans more likely to be diagnosed for DM compared with non-Hispanic whites, prevalence odds ratio (POR) 1.45, 95% confidence interval (CI) 1.30–1.62, while Hispanics were less likely to be diagnosed, POR = 0.98, 95% CI 0.87–1.09
Income was significantly higher among non-Hispanic whites (72.5%) compared with African Americans (55.1%) and Hispanics (57.7%)
Summary
Diabetes mellitus (DM) is one of the leading causes of death and disability in the United States, placing a significant public health burden both on individuals with DM as well as on the US health care system [1,2,3,4,5,6]. The age-adjusted prevalence rate of diagnosed DM in 2005 among the US population of age 20 years or more was 9.5%, while this rate was 13.3% in non-Hispanic blacks, 8.7% in non-Hispanic whites, and 9.5% in Hispanic [1, 3, 4, 8,9,10,11]. These data clearly reveal variations in the racial/ethnic distribution of diabetes mellitus. The mortality and prevalence of diabetes mellitus (DM) vary across racial/ethnic groups with African Americans/blacks being disproportionately affected. Racial/ethnic variability exists in DM prevalence and is unexplained by racial/ethnic variance in education, income, marital status, smoking, alcohol, physical activities, age, and sex
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