Minority Health Archive

Disparities in the prevalence of diabetes: is it race/ethnicity or socioeconomic status? Results from the Boston Area Community Health (BACH) survey.

Link, Carol L and McKinlay, John B (2009) Disparities in the prevalence of diabetes: is it race/ethnicity or socioeconomic status? Results from the Boston Area Community Health (BACH) survey. Ethnicity & disease, 19 (3). pp. 288-92. ISSN 1049-510X

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Abstract

OBJECTIVES: Many researchers and clinicians continue to believe that non-modifiable race/ ethnicity is a major contributor to diabetes, prompting a well-intentioned search for genetic and bio-physiological explanations. We seek to reinforce earlier findings showing that socioeconomic status is more strongly associated with diabetes prevalence than race/ ethnicity and suggests a very different and potentially modifiable etiologic pathway. METHODS: A community-based epidemiologic survey of 5503 Boston residents aged 30-79 years (1767 Black, 1877 Hispanic, 1859 White; 2301 men and 3202 women). RESULTS: After adjusting for age and sex, Blacks and Hispanics have statistically significantly increased odds of having diabetes: Black (OR, 2.0; 95% CI, 1.4-2.9) and Hispanic (2.4; CI 1.6-3.4) compared to Whites. If socioeconomic status, a combination of education and income, is added to the model, these odds are reduced for both Blacks (OR 1.6; CI, 1.1-2.2) and Hispanics (OR 1.6; CI, 1.1-2.3). In a multivariate logistic regression adjusting for age, sex, socioeconomic status, obesity, hypertension, gestational diabetes, physical activity, trouble paying for basics, health insurance status, and family history of diabetes, these odds are reduced further: Black (OR 1.0; CI, 0.7-1.5) and Hispanic (OR 1.3; CI, 0.9-2.1) and are no longer statistically significant. CONCLUSIONS: Consistent with other reports, we find socioeconomic status has a much stronger association with diabetes prevalence than race/ethnicity. Continuing to focus on race/ethnicity as a primary determinant of diabetes prevalence overemphasizes the importance of biomedical factors and diverts effort from socio-medical interventions such as improving social circumstances, access to effective care, and upstream redistributive social policies.


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Item Type: Article
Additional Information: This article is available at the publisher’s Web site. Access to the full text is subject to the publisher’s access restrictions. After clicking the link, scroll down the page to find the article.
Uncontrolled Keywords: Diabetes, Race/Ethnicity, Socioeconomic Status
Subjects: Health > Disparities
Health > Public Health > Chronic Illness & Diseases > Diabetes
Research
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Depositing User: Users 141 not found.
Date Deposited: 27 Jul 2011 21:40
Last Modified: 27 Jul 2011 21:40
Link to this item (URI): http://health-equity.pitt.edu/id/eprint/2876

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