The Socioeconomic Gradient of Diabetes Prevalence, Awareness, Treatment, and Control Among African Americans in the Jackson Heart Study
Open accessAbstract
Purpose Little research has focused on the social patterning of diabetes among African Americans. We examined the relationship between socioeconomic status (SES) and the prevalence, awareness, treatment, and control of diabetes among African Americans.Methods Education, income and occupation were examined among 4,303 participants (2,726 women and 1,577 men). Poisson regression estimated relative probabilities (RP) of diabetes outcomes by SES.Results The prevalence of diabetes was 19.6% in women and 15.9% in men. Diabetes awareness, treatment, and control were 90.0%, 86.8%, and 39.2% in women, respectively, and 88.2%, 84.4%, and 35.9% in men, respectively. In adjusted models, low-income men and women had greater probabilities of diabetes than high-income men and women (RP, 1.94; 95% confidence interval [CI], 1.28-2.92; and RP, 1.35; 95% CI, 1.04-1.74, respectively). Lack of awareness was associated with low education and low occupation in women (RP, 2.28; 95%CI 1.01-5.18; and RP, 2.62; 95% CI, 1.08-6.33, respectively) but not in men. Lack of treatment was associated with low education in women. Diabetes control was not patterned by SES.Conclusions Diabetes prevalence is patterned by SES, and awareness and treatment are patterned by SES in women but not men. Efforts to prevent diabetes in African Americans need to address the factors that place those of low SES at higher risk.
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Lower SES is associated with being less physically active, having a higher risk of diabetes, and being more likely to have hypertension and to smoke.
“Researchers report that lower SES is associated with being less physically active, 159 having a higher risk of diabetes, [160][161][162] and being more likely to have hypertension 163 and to smoke 164 -all of which are risk factors for dementia.”
From 2023 Alzheimer's disease facts and figures (2023) · cites this paper as [161]
Lower SES is associated with being less physically active, having a higher risk of diabetes, and being more likely to have hypertension and to smoke.
“Researchers report that lower SES is associated with being less physically active, 172 having a higher risk of diabetes, 173 , 174 , 175 and being more likely to have hypertension 176 and to smoke 177 — all of which are risk factors for dementia.”
From 2024 Alzheimer's disease facts and figures (2024) · cites this paper as [174]
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“0%) of participants with DM were aware of their DM status, which is much lower than other countries [28,29].”
BackgroundDo Stroke Patients Know Their Risk Factors?
Soomann, M., Vibo, R., & Kõrv, J. (2015) · Journal of Stroke and Cerebrovascular Diseases · doi:10.1016/j.jstrokecerebrovasdis.2015.10.029 · Cited by 8 · see citing works
Assessing Retention in a Free Diabetes Clinic
Buys, K. C., Selleck, C. S., & Buys, D. R. (2019) · The Journal for Nurse Practitioners · doi:10.1016/j.nurpra.2018.12.003 · Cited by 8 · see citing works
The Janus-like Association between Proton Pump Inhibitors and Dementia
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“43,44 It is plausible that a higher level of education allows better health literacy, and affords greater ability to navigate health care processes.”
Marsh, E. B., Lavretsky, H., Kasparian, N. A., Pike, N. A., Doyle, K. P., Aggarwal, N. T., Fullerton, H. J., Ivy, A. S., & Dlamini, N. (2026) · Stroke · doi:10.1161/str.0000000000000518 · Cited by 4 · see citing works
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“Religion, social category and wealth quartile showed an unusual pattern in our study for both women and men, deviating from the current literature in which the level of awareness is dependent on socioeconomic and cultural differences (Oko-sun and Dever 2002; Sims et al. 2011; Osman and Curzio 2012).”
A Precision Medicine Approach to the Care of Diabetes and Obesity in African Americans
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Level of understanding about diabetes mellitus among health seekers for diabetic related eye care
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Demographic Factors Associated with Morbidity
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“Has Diabetic card all the time 3 (7) Knowledge and perception about diabetes mellitus”
BackgroundInfluentialLessons Learned from the Jackson Heart Study
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Self-citationLi, Y., Sun, X., Wei, J., Wu, J., & Wang, Y. (2020) · doi:10.21203/rs.3.rs-36834/v1
“This may be due to their better access to higher quality medical care services [26].”
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“Evidence points to a race-poverty-place gradient for diabetes prevalence in African Americans [17,22].”
Naïditch, N. (2020) · doi:10.70675/e843388ezd42cz4292zaf5bz52ef076ba780
- Authors
- Sims, M., Diez Roux, A. V., Boykin, S., Sarpong, D., Gebreab, S. Y., Wyatt, S. B., Hickson, D., Payton, M., Ekunwe, L., & Taylor, H. A.
- Affiliations
- University of Mississippi Medical Center (US)
- University of Michigan (US)
- Jackson State University (US)
- Tougaloo College (US)
- Corresponding author
- Sims, Mario
- Venue
- Annals of Epidemiology
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 21
- Issue
- 12
- Pages
- 892-898
- ISSN
- 1047-2797 (ISSN-L)
- PMC
- PMC3192269
- OpenAlex
- W2047063260
- Cited by
- 81
- References
- 27
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 3 · 2023: 3 · 2022: 2 · 2021: 5 · 2020: 7 · 2019: 7 · 2018: 6 · 2017: 4 · 2016: 8 · 2015: 11 · 2014: 8 · 2013: 5 · 2012: 5
- FWCI
- 5.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (n01hc95170-30-0-1, n01hc95171-31-0-1, n01hc95172-31-0-1)
- National Heart, Lung, and Blood Institute (K01HL084682, N01 HC095171, N01 HC095172, N01HC95172, K01HL08468-04, N01 HC095170, N01 HC 95170, N01 HC-95171)
- National Institute on Minority Health and Health Disparities (P60MD002249)
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Keywords
- diabetes mellitus, socioeconomic status, African Americans, diabetes prevalence, diabetes awareness, diabetes treatment, glycemic control, income, occupation, sex differences, social patterning of health, Jackson Heart Study
- MeSH terms
- Awareness, Black or African American, Cross-Sectional Studies, Diabetes Mellitus, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Social Class, United States, Prevalence, Confidence Intervals, Poisson Distribution
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