Lam Tran1, Phoebe Tran2, Liem Tran3. 1. Department of Biostatistics, University of Michigan, 1415 Washington Heights, Ann Arbor, MI 48109, United States of America. Electronic address: lamtran@umich.edu. 2. Department of Chronic Disease Epidemiology, Yale University, 60 College Street, New Haven, CT 06510, United States of America. Electronic address: phoebe.tran@yale.edu. 3. Department of Geography, University of Tennessee, 1000 Phillip Fulmer Way, Knoxville, TN 37916, United States of America. Electronic address: ltran1@utk.edu.
Abstract
AIMS: To determine US diabetes screening estimates in Whites, Blacks, Hispanics, Asians, Native Hawaiians/Pacific Islanders, American Indians/Alaska Natives, and Others at the national, regional, and state level. METHODS: In this study of 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System data, we used logistic regression results to generate national, regional, and state screening marginal probabilities (average adjusted predictions (AAPs)) for each race in the two American Diabetes Association recommended screening groups1: asymptomatic overweight/obese people <45y with ≥1 diabetes risk factor and2 people ≥45y. RESULTS: Even after adjusting for sociodemographic and clinical factors, significant racial disparities in screening (p-value<.05) persist at all three geographic levels. Asians had the worst national, regional, and state level AAPs of all the races. Across all races, the Northeast had the highest regional screening levels (regional AAP: 48.4-78.58%) while the West had the lowest (regional AAP: 41.98-75.18%). CONCLUSIONS: Study findings indicate that sociodemographic and clinical factors do not fully explain racial disparities in diabetes screening. Further research on clinician and patient attitudes towards diabetes screening are warranted in order to design and implement initiatives in US areas where certain racial groups have particularly low diabetes screening levels.
AIMS: To determine US diabetes screening estimates in Whites, Blacks, Hispanics, Asians, Native Hawaiians/Pacific Islanders, American Indians/Alaska Natives, and Others at the national, regional, and state level. METHODS: In this study of 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System data, we used logistic regression results to generate national, regional, and state screening marginal probabilities (average adjusted predictions (AAPs)) for each race in the two American Diabetes Association recommended screening groups1: asymptomatic overweight/obesepeople <45y with ≥1 diabetes risk factor and2 people ≥45y. RESULTS: Even after adjusting for sociodemographic and clinical factors, significant racial disparities in screening (p-value<.05) persist at all three geographic levels. Asians had the worst national, regional, and state level AAPs of all the races. Across all races, the Northeast had the highest regional screening levels (regional AAP: 48.4-78.58%) while the West had the lowest (regional AAP: 41.98-75.18%). CONCLUSIONS: Study findings indicate that sociodemographic and clinical factors do not fully explain racial disparities in diabetes screening. Further research on clinician and patient attitudes towards diabetes screening are warranted in order to design and implement initiatives in US areas where certain racial groups have particularly low diabetes screening levels.
Authors: Roopradha Datta; Jennifer A Lucas; Miguel Marino; Benjamin Aceves; David Ezekiel-Herrera; Cirila Estela Vasquez Guzman; Sophia Giebultowicz; Katherine Chung-Bridges; Jorge Kaufmann; Andrew Bazemore; John Heintzman Journal: Diabetes Care Date: 2022-07-07 Impact factor: 17.152