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Cited by 230Health disparities and outcomesDiabetes Management and EducationDiabetes, Cardiovascular Risks, and Lipoproteins

Racial/Ethnic Disparities in Diabetes Quality of Care: the Role of Healthcare Access and Socioeconomic Status

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Canedo, Juan R., Miller, Stephania T., Schlundt, David, Fadden, Mary K., Sanderson, Maureen·2018·Journal of Racial and Ethnic Health Disparities
DOI 10.1007/s40615-016-0335-8PMC PMC5505804
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Abstract

Introduction Blacks, Hispanics, and Asians are disproportionately affected by diabetes. We assessed the state of racial/ethnic disparities in diabetes quality of care in the USA. Methods We analyzed cross-sectional data of adults diagnosed with Type 2 diabetes in the nationally representative 2013 Medical Expenditure Panel Survey. Differences in adherence to five diabetes quality of care recommendations (HbA1c twice yearly, yearly foot exam, dilated eye exam, blood cholesterol test, and flu vaccination) were examined by race/ethnicity while controlling for three social determinants of health (health insurance status, poverty, and education) and other demographic variables. Results Among adults with diabetes in the USA, 74.9% received two or more HbA1c tests, 69.0% had a foot exam, 64.9% had an eye exam, 85.4% had a cholesterol test, and 65.1% received flu vaccination in 2013. Compared to Whites, all were lower for Hispanics; HbA1c tests, eye exam, and flu vaccination were lower for Blacks; HbA1c tests, foot exam, and eye exam were lower for Asians. In adjusted models, the only remaining disparities in quality of care indicators were HbA1c tests for Hispanics (AOR 0.67, CI = 0.47-0.97), Blacks (AOR 0.59, CI = 0.40-0.88), and Asians (AOR 0.47, CI = 0.42-0.99); foot exams for Hispanics (AOR 0.65, CI = 0.47-0.90); and flu vaccination for Blacks (AOR 0.68, CI = 0.49-0.93). Conclusion Lack of insurance coverage and education explained some of the racial/ethnic disparities observed in diabetes quality of care. Improving quality of diabetes care could help reduce rates of diabetes complications, healthcare costs, and mortality.

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  • Studies have focused on African American and Latinx populations with type 2 diabetes who experienced higher mean HbA1c levels than non-Latinx White populations.

    “Studies have focused on African American and Latinx populations with T2D who experienced higher mean hemoglobin A1c (HbA1c) levels than non-Latinx White populations.11,12,13,14”

    From Mobile Health Intervention in Patients With Type 2 Diabetes: A Randomized Clinical Trial (2023) · cites this paper as [12]

    The Methods and Results sections examine adults with type 2 diabetes and compare Hispanic and Black participants with White participants. But the reported HbA1c outcome is how often participants received tests, not their mean HbA1c levels; the copy does not establish the claimed difference in levels. No page number is available in the indexed passages. (LLM, conf=0.85)

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Authors
Canedo, J. R., Miller, S. T., Schlundt, D., Fadden, M. K., & Sanderson, M.
Affiliations
  • Meharry Medical College (US)
  • Vanderbilt University (US)
Corresponding author
Canedo, Juan R.
ORCID
Venue
Journal of Racial and Ethnic Health Disparities
Publisher
Springer Science and Business Media LLC
Published
2017-01-11
Volume
5
Issue
1
Pages
7-14
ISSN
  • 2196-8837 (ISSN-L)
  • 2197-3792
DOI
10.1007/s40615-016-0335-8
PMC
PMC5505804
OpenAlex
W2573924956
Cited by
230
References
3
Citations by year
2026: 13 · 2025: 37 · 2024: 52 · 2023: 33 · 2022: 38 · 2021: 26 · 2020: 17 · 2019: 6 · 2018: 5 · 2017: 3
FWCI
9.43
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (unspecified)
Locations
  • Journal of Racial and Ethnic Health Disparities (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
Vanderbilt Institute for Clinical and Translational Research (UL1-TR000445)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
racial and ethnic disparities, type 2 diabetes, health care access, socioeconomic status, social determinants of health, health insurance coverage, poverty, educational attainment, HbA1c testing, foot examination, dilated eye examination, cholesterol screening, influenza vaccination, Hispanic Americans, African Americans, Asian Americans
MeSH terms
Adolescent, Adult, Black or African American, Cross-Sectional Studies, Diabetes Mellitus, Type 2, Female, Health Services Accessibility, Hispanic or Latino, Humans, Male, Middle Aged, Social Class, United States, Quality Indicators, Health Care, Asian People, Healthcare Disparities

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