Socioeconomic status and race/ethnicity independently predict health decline among older diabetics
Open accessAbstract
BACKGROUND: There are pervasive racial and socioeconomic differences in health status among older adults with type 2 diabetes. The extent to which racial/ethnic and socioeconomic disparities unfold to differential health outcomes has yet to be investigated among older adults with diabetes. This study examines whether or not race/ethnicity and SES are independent predictors of steeper rates of decline in self-rated health among older adults in the U.S. with type 2 diabetes. METHODS: The study population was a subset of diabetic adults aged 65 and older from the Health and Retirement Study. Respondents were followed up to 16 years. Multilevel cumulative logit regression models were used to examine the contributions of socioeconomic indicators, race/ethnicity, and covariates over time. Health decline was measured as a change in self-reported health status over the follow-up period. RESULTS: Relative to whites, blacks had a significantly lower cumulative odds of better health status over time (OR: 0.61, p < .0001). Hispanics reported significantly lower cumulative odds better health over time relative to whites (OR: 0.59, p < .05). Although these disparities narrowed when socioeconomic characteristics were added to the model, significant differences remained. Including socioeconomic status did not remove the health effects of race/ethnicity among blacks and Hispanics. CONCLUSIONS: The author found that race/ethnicity and some socioeconomic indicators were independent predictors of health decline among older adults with diabetes.
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Race was included not as a biological variable but as a structural equity proxy, reflecting disparities in healthcare access, treatment patterns, and social conditions that are associated with diabetes outcomes and health decline.
“Race was included not as a biological variable but as a structural equity proxy, reflecting disparities in healthcare access, treatment patterns, and social conditions that are associated with diabetes outcomes and health decline [32,42].”
From Machine learning-driven risk prediction for post-hospitalization diabetes case management: Integrating clinical and social determinants of health (2026) · cites this paper as [42]
The Background (page unavailable) links racial and ethnic health disparities to differences in medical decision-making, quality and access to care, discrimination, and socioeconomic conditions. The Discussion (page unavailable) finds race/ethnicity predicts health decline among older adults with diabetes. The paper does not explicitly say race was included as a structural equity proxy rather than a biological variable, and its Conclusions describe the proposed mechanisms as needing further study. (LLM, conf=0.84)
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ADULT LEARNING AND THE EFFECT OF EDUCATION AND GENDER INTERACTION ON TYPE 2 DIABETICS
Nur, A. H. (2017) · Sycamore Scholars (Indiana State University)
- Authors
- Nicklett, E. J.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Nicklett, Emily J
- ORCID
- Nicklett, Emily J
- Venue
- BMC Public Health
- Published
- 2011-09-02
- Volume
- 11
- Issue
- 1
- Pages
- 684-684
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3175469
- OpenAlex
- W2030432015
- Cited by
- 32
- References
- 39
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 1 · 2021: 4 · 2020: 3 · 2019: 2 · 2018: 1 · 2017: 2 · 2016: 3 · 2015: 4 · 2014: 3 · 2013: 3 · 2012: 3
- FWCI
- 2.96
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- University of Michigan
- Agency for Healthcare Research and Quality
- College of Pharmacy, University of Michigan
- National Institute on Aging
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Education
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Keywords
- type 2 diabetes, older adults, socioeconomic status, race and ethnicity, health deterioration, self-rated health, racial disparities, Hispanic health, Black health, health disparities
- MeSH terms
- Aged, Aged, 80 and over, Black or African American, Diabetes Mellitus, Type 2, Female, Follow-Up Studies, Hispanic or Latino, Humans, Male, Social Class, United States, Black People, White People, Health Status Disparities, Diagnostic Self Evaluation
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