Table 4

Fully adjusted models for guideline-recommended care receipt for annual A1c test, annual foot examination and annual eye examination, all adults with diabetes in 2008–2010*

	≥2 A1c tests last year		Annual foot examination		Annual eye examination
Variables	OR (95% CI)	p Value	OR (95% CI)	p Value	OR (95% CI)	p Value
County economic level [competitive]
Distressed	1.046 (0.789 to 1.388)	0.755	0.740 (0.556 to 0.986)	0.040	0.784 (0.580 to 1.060)	0.114
At-risk	0.974 (0.766 to 1.238)	0.827	0.592 (0.457 to 0.768)	<0.001	0.791 (0.618 to 1.011)	0.061
Transitional	0.957 (0.782 to 1.171)	0.668	0.768 (0.615 to 0.959)	0.020	0.889 (0.719 to 1.099)	0.277
Non-Appalachian	0.920 (0.761 to 1.112)	0.390	0.798 (0.648 to 0.984)	0.035	0.893 (0.732 to 1.089)	0.264
Age, years	0.995 (0.991 to 0.998)	0.001	1.004 (1.001 to 1.008)	0.019	1.020 (1.017 to 1.023)	<0.001
Male	0.917 (0.860 to 0.977)	0.007	1.114 (1.039 to 1.194)	0.002	0.934 (0.872 to 1.001)	0.054
Race/ethnicity [NH White]
NH Black	0.831 (0.758 to 0.911)	<0.001	1.416 (1.266 to 1.583)	<0.001	1.238 (1.119 to 1.370)	<0.001
Hispanic	0.680 (0.585 to 0.791)	<0.001	0.791 (0.675 to 0.927)	0.004	1.223 (1.040 to 1.4 39)	0.015
Other/unknown	0.877 (0.776 to 0.991)	0.035	1.034 (0.892 to 1.198)	0.657	1.066 (0.928 to 1.224)	0.364
Married	1.225 (1.148 to 1.307)	<0.001	1.080 (1.003 to 1.164)	0.041	1.076 (1.003 to 1.154)	0.040
Household income [<$20 000]
$20 000–$34 999	1.019 (0.932 to 1.115)	0.677	0.943 (0.856 to 1.039)	0.236	1.117 (1.016 to 1.229)	0.022
$35 000–$74 999	1.147 (1.040 to 1.263)	0.006	0.959 (0.859 to 1.070)	0.450	1.170 (1.056 to 1.297)	0.003
≥$75 000	1.281 (1.130 to 1.451)	<0.001	0.960 (0.835 to 1.103)	0.561	1.215 (1.065 to 1.385)	0.004
Unknown	0.844 (0.766 to 0.930)	0.001	0.860 (0.770 to 0.960)	0.007	1.120 (1.005 to 1.247)	0.040
Education [<some high school]
Some high school	1.147 (0.977 to 1.347)	0.094	1.207 (1.020 to 1.429)	0.029	1.079 (0.907 to 1.285)	0.390
High school graduate or GED	1.412 (1.231 to 1.619)	<0.001	1.201 (1.042 to 1.384)	0.011	1.195 (1.031 to 1.385)	0.018
Some college	1.647 (1.429 to 1.899)	<0.001	1.275 (1.099 to 1.478)	0.001	1.258 (1.080 to 1.465)	0.003
College graduate or higher	1.976 (1.698 to 2.299)	<0.001	1.377 (1.180 to 1.608)	<0.001	1.443 (1.228 to 1.695)	<0.001
Employed/self-employed	0.996 (0.919 to 1.081)	0.929	1.017 (0.933 to 1.108)	0.705	0.933 (0.859 to 1.014)	0.101
BMI [<25 kg/m²]
25–29.9 kg/m²	1.179 (1.078 to 1.289)	<0.001	1.215 (1.099 to 1.344)	<0.001	1.049 (0.947 to 1.162)	0.357
≥30 kg/m²	1.280 (1.174 to 1.397)	<0.001	1.324 (1.200 to 1.461)	<0.001	0.992 (0.901 to 1.092)	0.874
Unknown	1.185 (1.018 to 1.381)	0.029	1.225 (1.030 to 1.457)	0.022	1.010 (0.860 to 1.187)	0.901
Smoking [never]
Past	1.066 (1.000 to 1.137)	0.049	0.947 (0.882 to 1.017)	0.131	0.949 (0.885 to 1.017)	0.139
Current	0.876 (0.797 to 0.963)	0.006	0.854 (0.771 to 0.946)	0.002	0.722 (0.655 to 0.796)	0.000
Exercise	1.141 (1.072 to 1.215)	<0.001	1.234 (1.152 to 1.321)	<0.001	1.159 (1.084 to 1.239)	<0.001
History of heart attack	0.887 (0.806 to 0.976)	0.014	1.041 (0.940 to 1.153)	0.437	0.985 (0.888 to 1.094)	0.782
Coronary heart disease	1.156 (1.065 to 1.255)	0.001	1.093 (0.999 to 1.196)	0.053	1.024 (0.940 to 1.117)	0.585
Stroke	0.900 (0.814 to 0.996)	0.041	1.007 (0.898 to 1.129)	0.900	1.072 (0.968 to 1.188)	0.181
Activity limitations	1.218 (1.142 to 1.300)	<0.001	1.095 (1.018 to 1.179)	0.015	0.937 (0.874 to 1.005)	0.070
Insulin user	1.763 (1.634 to 1.903)	<0.001	1.998 (1.836 to 2.174)	<0.001	1.455 (1.343 to 1.576)	<0.001
Diabetes duration [<5 years]
5–9 years	1.384 (1.274 to 1.503)	<0.001	1.326 (1.214 to 1.448)	<0.001	1.146 (1.051 to 1.250)	0.002
≥10 years	1.591 (1.474 to 1.717)	<0.001	1.646 (1.520 to 1.784)	<0.001	1.462 (1.348 to 1.586)	<0.001
Has health insurance	1.378 (1.217 to 1.560)	<0.001	1.343 (1.176 to 1.533)	<0.001	1.625 (1.434 to 1.841)	<0.001
Has personal doctor	2.152 (1.842 to 2.513)	<0.001	1.490 (1.276 to 1.740)	<0.001	1.052 (0.896 to 1.235)	0.536
Cost barrier to medical Care	0.759 (0.686 to 0.839)	<0.001	0.797 (0.716 to 0.888)	<0.001	0.683 (0.616 to 0.758)	<0.001
Routine check-up last 12 months	1.852 (1.692 to 2.028)	<0.001	2.390 (2.175 to 2.626)	<0.001	1.822 (1.656 to 2.004)	<0.001
Urban residence	1.053 (0.986 to 1.124)	0.126	1.036 (0.967 to 1.111)	0.312	1.107 (1.033 to 1.185)	0.004
Physicians per 100 000 population in County	0.961 (0.888 to 1.040)	0.323	0.987 (0.971 to 1.003)	0.108	0.987 (0.969 to 1.004)	0.134
FQHCs in county [none]
1	1.068 (0.973 to 1.171)	0.166	1.049 (0.952 to 1.156)	0.330	0.990 (0.901 to 1.087)	0.826
2 or more	1.003 (0.926 to 1.086)	0.938	1.075 (0.987 to 1.171)	0.096	1.021 (0.940 to 1.108)	0.624
County HPSA designation [none]
Part county	0.935 (0.845 to1.036)	0.199	0.977 (0.878 to 1.088)	0.678	0.900 (0.808 to 1.003)	0.056
Whole county	1.026 (0.930 to 1.133)	0.610	1.025 (0.924 to 1.138)	0.637	0.954 (0.860 to 1.060)	0.381

*Reference categories are given in brackets.
BMI, body mass index; FQHC, federally qualified health centre; GED, general education development; HPSA, health professional shortage area; NH, non-Hispanic.