Health Insurance and Diabetes Among Multiracial Men: The Mediation Effects of Usual Source of Care

Abstract

Background. Health insurance and having a usual source of care is important in diabetes management for multiethnic men. Few studies focus on determining whether usual source of care mediates the association between health insurance and diabetes among men. Methods. Using data from the 2005 California Health Interview Survey, responses from 17,472 men were analyzed to examine the extent to which a usual source of health care mediates the relationship between health insurance and diabetes. Results. Sobel-Goodman tests for mediation indicated the largest effects between Latino and White men. For African American and Asian men, usual source of care did not serve as a significant mediation factor between health insurance and diabetes. Discussion. Findings highlight a need for more research on the importance of having a usual source of care along with consistent health insurance type for multiracial men.

Sleep quality partially mediates the association between type 2 diabetes and psychological distress in Native Hawaiian and Pacific Islander adults in the United States: Analysis of the 2014 National Health Interview Survey.

“…The following covariates known to be associated both with psychological distress and diabetes were a priori identified from existing literature: (a) sociodemographic: age, sex, marital status (Tavares & Aassve, 2013; Whisman, Li, Sbarra, & Raison, 2014), education attainment, employment, poverty level, nativity, and health insurance status (The American Diabetes Association, 2011; Doucette, Salas, Wang, & Scherrer, 2017; Ford, Narayan, & Mehta, 2016; Gadalla, 2009; Nayak et al, 2014; Ward & Martinez, 2015); (b) health-risk behaviors: sedentarity (Okoro et al, 2014; Wilmot et al, 2012), current everyday cigarette smokers (Carter, van der Deen, Wilson, & Blakely, 2014; Willi, Bodenmann, Ghali, Faris, & Cornuz, 2007), and current heavy alcohol drinkers (Bonevski, Regan, Paul, Baker, & Bisquera, 2014; Carlsson, Hammar, Grill, & Kaprio, 2003); and (c) chronic health conditions other than diabetes: obesity (Knoesen et al, 2012; Neeland et al, 2012; Ojike et al, 2016), hypertension (Ferrannini & Cushman, 2012; Knoesen et al, 2012), hyperlipidemia (Nakaya et al, 2014), liver conditions and kidney failure (Bhatt & Smith, 2015), heart diseases and stroke (Nakaya et al, 2014; Tuomilehto, Rastenyte, Jousilahti, Sarti, & Vartiainen, 1996), chronic obstructive pulmonary disease, asthma (Adams et al, 2004; Nakaya et al, 2014; Song, Klevak, Manson, Buring, & Liu, 2010), and cancer (Nakaya et al, 2014; Tsilidis, Kasimis, Lopez, Ntzani, & Ioannidis, 2015; Zelenko & Gallagher, 2014), as well as having a usual source of care (Hastings & Hawkins, 2010; Li, Dick, Fiscella, Conwell, & Friedman, 2011). (See Table 1 for definitions of these covariates.…”