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Assessing Diabetes and Factors Associated with Foregoing Medical Care among Persons with Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in the U.S. (2011–2015)

Author

Listed:
  • Samuel D. Towne

    (Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77846, USA)

  • Jane Bolin

    (Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX 77846, USA)

  • Alva Ferdinand

    (Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX 77846, USA)

  • Emily Joy Nicklett

    (School of Social Work, University of Michigan, Ann Arbor, MI 48109, USA)

  • Matthew Lee Smith

    (Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77846, USA
    Institute of Gerontology, Department of Health Promotion and Behavior, College of Public Health, University of Georgia, Athens, GA 30602, USA)

  • Marcia G. Ory

    (Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX 77846, USA)

Abstract

Objective : Identify individual- and place-based factors associated with diagnosed diabetes and forgone medical care among those diagnosed with diabetes. Background : Diabetes affects millions of individuals globally. In the U.S. alone the prevalence rate of diagnosed diabetes has more than doubled over the past 20 years (4.2% in 1994 to 10% in 2014). Methods : The Behavioral Risk Factor Surveillance System (2011–2015) was used to identify factors associated with self-reported diabetes diagnoses (ever diagnosed) among U.S. adults. Logistic regression modeled: (1) the likelihood of having diabetes; (2) the likelihood of forgone medical care among those with diabetes, given appropriate medical care has been linked to preventing complications associated with diabetes. Results : Rates of diabetes remained relatively stable from 2011 to 2015. The likelihood of diabetes was higher ( p < 0.01) among racial and ethnic minority groups, men, those with lower incomes and those with lower education. Place-based disparities indicating a higher likelihood of having a diagnosis of diabetes were found for those living in rural areas (urban versus rural, unadjusted OR = 0.844–0.908; p < 0.01) and those living in the South (North, Midwest, and Western/Pacific regions versus the South, unadjusted OR = 0.794–0.889; p < 0.01). Similar results were found with forgone medical care among those diagnosed with diabetes being more likely in the South (North, Midwest, and Western/Pacific regions versus the South, unadjusted OR = 0.542–0.819). In fully-adjusted analyses, the prevalence of diabetes and forgone medical care among those diagnosed with diabetes was higher for those with lower incomes, from several racial/ethnic minority groups, and in the South versus most other regions. Conclusions : Identifying at-risk groups informs targets for prevention and assists efforts to address chronic disease self-management among those already diagnosed with diabetes.

Suggested Citation

  • Samuel D. Towne & Jane Bolin & Alva Ferdinand & Emily Joy Nicklett & Matthew Lee Smith & Marcia G. Ory, 2017. "Assessing Diabetes and Factors Associated with Foregoing Medical Care among Persons with Diabetes: Disparities Facing American Indian/Alaska Native, Black, Hispanic, Low Income, and Southern Adults in," IJERPH, MDPI, vol. 14(5), pages 1-17, April.
    • Handle: RePEc:gam:jijerp:v:14:y:2017:i:5:p:464-:d:96855
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    References listed on IDEAS

    as
    1. Gaskin, D.J. & Thorpe, R.J., Jr. & McGinty, E.E. & Bower, K. & Rohde, C. & Young, J.H. & LaVeist, T.A. & Dubay, L., 2014. "Disparities in diabetes: The nexus of race, poverty, and place," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2147-2155.
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    Cited by:

    1. Samuel D. Towne Jr., 2017. "Socioeconomic, Geospatial, and Geopolitical Disparities in Access to Health Care in the US 2011–2015," IJERPH, MDPI, vol. 14(6), pages 1-15, May.

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