Osborn, C. Y. and Cavanaugh, K. and Wallston, K. A. and White, R. O. and Rothman, R. L.
OBJECTIVE: Understanding the reasons and eliminating the pervasive health disparities in diabetes is a major research, clinical, and health policy goal. We examined whether health literacy, general numeracy, and diabetes-related numeracy explain the association between African American race and poor glycemic control (A1C) in patients with diabetes. RESEARCH DESIGN AND METHODS: Adults with type 2 diabetes (n = 383) were enrolled in a cross-sectional study at primary care and diabetes clinics at three medical centers. Data collected included the following: self-reported race, health literacy, general numeracy, diabetes-related numeracy, A1C, and sociodemographic factors. A series of structural equation models were estimated to explore the interrelations between variables and test for mediation. RESULTS: In model 1, younger age (r = -0.21, P < 0.001), insulin use (r = 0.27, P < 0.001), greater years with diabetes (r = 0.16, P < 0.01), and African American race (r = 0.12, P < 0.01) were all associated with poorer glycemic control. In model 2, diabetes-related numeracy emerged as a strong predictor of A1C (r = -0.46, P < 0.001), reducing the association between African American and poor glycemic control to nonsignificance (r = 0.10, NS). In model 3, African American race and older age were associated with lower diabetes-related numeracy; younger age, insulin use, more years with diabetes, and lower diabetes-related numeracy were associated with poor glycemic control. CONCLUSIONS: Diabetes-related numeracy reduced the explanatory power of African American race, such that low diabetes-related numeracy, not African American race, was significantly related to poor glycemic control. Interventions that address numeracy could help to reduce racial disparities in diabetes.
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|Additional Information:||Full free text available at publisher's web site.|
|Subjects:||Health > Disparities|
Health > Public Health > Chronic Illness & Diseases > Diabetes
|Depositing User:||Users 141 not found.|
|Date Deposited:||27 Jul 2011 22:29|
|Last Modified:||27 Jul 2011 22:29|
|Link to this item (URI):||http://health-equity.pitt.edu/id/eprint/2878|
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