Joan M O'Connell1, Jennifer E Rockell1,2, Judith C Ouellet1,3, Sherri Yoder4, Kimberly E Lind1,5, Charlton Wilson6, Andrew Friedson7, Spero M Manson1. 1. Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA. 2. Telligen, 7730 E Belleview Ave, Suite 300, Greenwood Village, CO, USA. 3. Department of Health and Behavioral Sciences, University of Colorado Denver, Denver, CO, USA. 4. Retired from the Indian Health Service, USA. 5. Mel & Enid Zuckerman College of Public Health, University of Arizona, USA. 6. Chief Medical Officer, Mercy Care, Phoenix, AZ, USA. 7. Department of Economics, University of Colorado Denver, Denver, Colorado, USA.
Abstract
AIMS: American Indians and Alaska Native (AI/ANs) peoples experience significant health disparities compared to the U.S. general population. We report comorbidities among AI/ANs with diabetes to guide efforts to improve their health status. METHODS: Drawing upon data for over 640,000 AI/ANs who used services funded by the Indian Health Service, we identified 43,518 adults with diabetes in fiscal year 2010. We reported the prevalence of comorbidities by age and cardiovascular disease (CVD) status. Generalized linear models were estimated to describe associations between CVD and other comorbidities. RESULTS: Nearly 15% of AI/AN adults had diabetes. Hypertension, CVD and kidney disease were comorbid in 77.9%, 31.6%, and 13.3%, respectively. Nearly 25% exhibited a mental health disorder; 5.7%, an alcohol or drug use disorder. Among AI/ANs with diabetes absent CVD, 46.9% had 2 or more other chronic conditions; the percentage among adults with diabetes and CVD was 75.5%. Hypertension and tobacco use disorders were associated with a 71% (95% CI for prevalence ratio: 1.63 - 1.80) and 33% (1.28 - 1.37) higher prevalence of CVD, respectively, compared to adults without these conditions. CONCLUSION: Detailed information on the morbidity burden of AI/ANs with diabetes may inform enhancements to strategies implemented to prevent and treat CVD and other comorbidities.
AIMS: American Indians and Alaska Native (AI/ANs) peoples experience significant health disparities compared to the U.S. general population. We report comorbidities among AI/ANs with diabetes to guide efforts to improve their health status. METHODS: Drawing upon data for over 640,000 AI/ANs who used services funded by the Indian Health Service, we identified 43,518 adults with diabetes in fiscal year 2010. We reported the prevalence of comorbidities by age and cardiovascular disease (CVD) status. Generalized linear models were estimated to describe associations between CVD and other comorbidities. RESULTS: Nearly 15% of AI/AN adults had diabetes. Hypertension, CVD and kidney disease were comorbid in 77.9%, 31.6%, and 13.3%, respectively. Nearly 25% exhibited a mental health disorder; 5.7%, an alcohol or drug use disorder. Among AI/ANs with diabetes absent CVD, 46.9% had 2 or more other chronic conditions; the percentage among adults with diabetes and CVD was 75.5%. Hypertension and tobacco use disorders were associated with a 71% (95% CI for prevalence ratio: 1.63 - 1.80) and 33% (1.28 - 1.37) higher prevalence of CVD, respectively, compared to adults without these conditions. CONCLUSION: Detailed information on the morbidity burden of AI/ANs with diabetes may inform enhancements to strategies implemented to prevent and treat CVD and other comorbidities.
Entities:
Keywords:
Alaska Natives; American Indians; Cardiovascular Disease; Diabetes; Kidney Disease; Mental Health Disorders
Authors: Pyone Cho; Linda S Geiss; Nilka Rios Burrows; Diana L Roberts; Ann K Bullock; Michael E Toedt Journal: Am J Public Health Date: 2014-04-22 Impact factor: 9.308
Authors: David K Espey; Melissa A Jim; Nathaniel Cobb; Michael Bartholomew; Tom Becker; Don Haverkamp; Marcus Plescia Journal: Am J Public Health Date: 2014-04-22 Impact factor: 9.308
Authors: Kelly Moore; Luohua Jiang; Spero M Manson; Janette Beals; William Henderson; Katherine Pratte; Kelly J Acton; Yvette Roubideaux Journal: Am J Public Health Date: 2014-09-11 Impact factor: 9.308