Research in Social and Administrative Pharmacy
Original ResearchRacial difference in diabetes preventive care
Section snippets
Background
According to the American Diabetes Association (ADA), 8.3% of the United States total population had diabetes in 2011.1 In 2006, diabetes was the seventh leading cause of death in the United States.2 Disparities in diabetes are well documented. A national survey in 2004–2006 found that there is a high prevalence of diabetes in non-Hispanic black/African Americans (11.8%), and in Hispanics (10.4%).3 There are enormous economic costs associated with diabetes and its secondary complications,
Methods
Data for this analysis were obtained from the 2008 Medical Expenditure Panel Survey (MEPS), a nationally representative survey of non-institutionalized U.S. residents sponsored by the Agency for Healthcare Research and Quality (AHRQ) and the National Center for Health Statistics (NCHS). The data set was chosen because of its sample size, racial composition, national sample, and set of variables hypothesized to influence the receipt of diabetes preventive care based on the Andersen model. The
Results
Table 1 shows the sample characteristics for adult diabetes patients. About 69% of the sample patients were non-Hispanic white, 15% were Hispanic, and 16% were African American. The mean patient age was 60 years, 50% were female, 82% lived in metropolitan area, 47% had an annual income of $44,361 or above, and 8% had no health insurance. Seventy four percent of these patients received an A1C test at least twice in the past year, 65% received a diabetic foot exam in the past year, and 63%
Discussion
To the authors' best knowledge, this is the first study to use path analysis to assess racial disparity in diabetes preventive care using the Andersen model. Using a national representative sample this study found that there is a racial difference in obtaining diabetes preventive care in terms of getting at least two A1C tests, a diabetic foot exam, and an eye exam. Compared to their white peers, African Americans were less likely to receive these elements of preventive care, while Hispanics
Conclusion
In conclusion, this study suggests that minority, rural, low-income, uninsured, and young diabetes patients are at a higher risk of not receiving diabetes preventive care. To the authors' best knowledge, this is the first study to use path analysis to assess racial disparity in diabetes preventive care and to do so drawing on the Andersen's Health Care Utilization Behavior model. In response to the disparity findings reinforced in this study, pharmacists have a need and an opportunity to help
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