The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #70423

Marea Berni Tumber, BA, Department of Community Health / PhD Program - Epidemiology, Brown University, Box G-HLL, Providence, RI 02912, 401-863-9887, Marea_Tumber@Brown.edu and Kate L. Lapane, PhD, Department of Gerontology, Brown University, 171 Meeting Street, Box GB-222, Providence, RI 02912.

The prevalence of physician-diagnosed diabetes has been steadily increasing in the U.S. population, and there is evidence that the prevalence of undiagnosed diabetes is also on the rise. Additionally, there are apparent racial disparities in the prevalence of diabetes. In this analysis, we estimated the effect of inadequate access to health care on the increased prevalence of undiagnosed diabetes in people aged 40 and over, using NHANES III data. Lack of access to health care was associated with undiagnosed diabetes. The following measures served as proxies for access to health care, and were associated with undiagnosed diabetes: race/ethnicity (OR=1.44, 95% CI 1.19-1.73), poverty (OR=1.39, 95% CI=1.14-1.69), less than 12 years of education (OR=1.41, 95% CI = 1.18-1.70), lack of health insurance (OR=1.37, 95% CI = 1.02-1.82) and primary language other than English (OR=1.80, 95% CI=1.46-2.21), in the adjusted regression models. In addition, the health care access measures that we examined appear to indicate that people of color are less likely than whites to have access to health care. The populations at highest risk for diabetes face additional challenges in being diagnosed with the disease. Concerted public health efforts are needed to reduce the racial/ethnic and socioeconomic barriers to quality health care. Some barriers, such as language, may be diminished through well-designed, culturally appropriate interventions, such as the hiring and training of health translators. Other barriers, such as discrimination, will require social and political actions that address the economic and social injustices in this country.

Learning Objectives:

At the conclusion of the session, attendees will be able to:
• Describe racial/ethnic and socioeconomic barriers to health care.
• Understand the importance of proper diabetes screening and care.

Keywords: Access, Diabetes

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.