Ethnic disparities in diabetes care: myth or reality?

Meneghini, Luigi

doi:10.1097/med.0b013e3282f5dbb8

Cited by 5 publications

(11 citation statements)

References 41 publications

(32 reference statements)

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“…This finding is most concerning in obese patients <45 years, because screening in this subpopulation depends on the presence and recognition of risk factors such as high-risk ethnicity. Extensive data demonstrate that minorities are more likely to have diabetes and to suffer comparatively increased morbidity and worse glycemic control (3,10,11), so these screening inadequacies are concerning.…”

Section: Discussionmentioning

confidence: 99%

“…The reasons that health care disparities persist are not always apparent and likely multifactorial but clearly affect patients with a variety of medical conditions, including type 2 diabetes, a disease that has reached epidemic proportions in this country. In multiple studies, ethnicity has been identified as a risk factor not only for having type 2 diabetes but for increased morbidity and mortality with the disease (3). However, factors, such as lack of both health care insurance and access to care (3,4), which occur at higher rates in minority patients, may contribute to these findings.…”

mentioning

confidence: 99%

“…In multiple studies, ethnicity has been identified as a risk factor not only for having type 2 diabetes but for increased morbidity and mortality with the disease (3). However, factors, such as lack of both health care insurance and access to care (3,4), which occur at higher rates in minority patients, may contribute to these findings. There are limited data investigating type 2 diabetes case finding in general, with only minimal data including a minority population that is both insured and also presenting for health care.…”

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confidence: 99%

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Minority Status and Diabetes Screening in an Ambulatory Population

et al. 2011

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OBJECTIVEEthnicity has been identified as a risk factor not only for having type 2 diabetes but for increased morbidity and mortality with the disease. Current American Diabetes Association (ADA) guidelines advocate screening high-risk minorities for diabetes. This study investigates the effect of minority status on diabetes screening practices in an ambulatory, insured population presenting for yearly health care.RESEARCH DESIGN AND METHODSThis is a retrospective population–based study of patients in a large, Midwestern, academic group practice. Included patients were insured, had ≥1 primary care visit yearly from 2003 to 2007, and did not have diabetes but met ADA criteria for screening. Odds ratios (ORs), 95% confidence intervals (CI), and predicted probabilities were calculated to determine the relationship between screening with fasting glucose, glucose tolerance test, or hemoglobin A1c and patient and visit characteristics.RESULTSOf the 15,557 eligible patients, 607 (4%) were of high-risk ethnicity, 61% were female, and 86% were ≥45 years of age. Of the eight high-risk factors studied, after adjustment, ethnicity was the only factor not associated with higher diabetes screening (OR = 0.90 [95% CI 0.76–1.08]) despite more primary care visits in this group. In overweight patients <45 years, where screening eligibility is based on having an additional risk factor, high-risk ethnicity (OR 1.01 [0.70–1.44]) was not associated with increased screening frequency.CONCLUSIONSIn an insured population presenting for routine care, high-risk minority status did not independently lead to diabetes screening as recommended by ADA guidelines. Factors other than insurance or access to care appear to affect minority-preventive care.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Minority Status and Diabetes Screening in an Ambulatory Population

et al. 2011

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“…Racial and ethnic minority group members have experienced not only a greater increase in the prevalence in diabetes but also higher rates of complications and mortality (Harris, 2001;Lanting, Mackenbach, Lamberts, & Bootsma, 2005). In 2005, the projected prevalence of diabetes among individuals aged 20 and older was 8% among Whites, 14% among Hispanics, 15% among African Americans, and 18% among American Indians and Alaska Natives (Meneghini, 2008), with the largest increase in the prior decade being among American Indians and Asian Americans (Mokdad et al, 2000) and the current highest risk group being Hispanics (Fernandez, 2007;Perez-Escamilla & Putnik, 2007;Sundquist & Winkleby, 2000).…”

Section: Diabetesmentioning

confidence: 99%

“…Licensing exams in the various health professions should test for performance measures on working with disparate racial and ethnic groups. Continuing education of healthcare providers should focus on helping providers develop ongoing one-to-one interactions tailored to the culture and health literacy of community members (Meneghini, 2008).…”

Section: What Are Educators To Do?mentioning

confidence: 99%

Health Disparities: A Primer for Public Health Social Workers

Keefe

2010

Social Work in Public Health

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Socioeconomic determinants associated with willingness to participate in medical research among a diverse population

Svensson

Ramírez

Peres

et al. 2012

Contemporary Clinical Trials

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Introduction Although it is federally-mandated that racial/ethnic minorities be included in research studies, recruiting diverse populations remains a challenge. This is particularly difficult when research involves children. The purpose of this study was to assess attitudes and beliefs toward medical research among a racially and socioeconomically diverse population of parents of school children. Methods A cross-sectional parent-report survey was conducted in New York City public elementary schools using stratified random selection to obtain a diverse population. Fear of medical research and likelihood to participate in medical research were assessed using a validated questionnaire. Differences in fear/likelihood to participate in research across race/ethnicity and socioeconomic characteristics were evaluated. Results In general, parents were afraid of their child “being treated as a guinea pig”, but were willing to allow their child to participate in research if asked by their own doctor. Factors associated with a lower score on fear towards research were; primary language other than English (OR=0.59), access to an interpreter (OR=0.73) and access to medical service within a day (OR=0.51). Latinos had the highest fear score (OR=1.87) compared to Whites. Asians were the ethnic group most likely to participate in research (OR=1.71). Low education level (OR=2.18) and public health insurance (OR=1.37) were associated with a higher score for likelihood of allowing one’s child to participate in medical research. Conclusion Minority parents reported more fear allowing their children to participate in medical research, but were as likely to consent their children’s participation, especially if asked by their own physician.

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Ethnic disparities in diabetes care: myth or reality?

Abstract: A growing body of data is emerging to not only highlight the disparities in healthcare we still confront in the USA, but to also implement strategies to successfully address and resolve those challenges.

Cited by 5 publications

References 41 publications

Minority Status and Diabetes Screening in an Ambulatory Population

Minority Status and Diabetes Screening in an Ambulatory Population

Health Disparities: A Primer for Public Health Social Workers

Socioeconomic determinants associated with willingness to participate in medical research among a diverse population

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