Racial and Ethnic Disparities in Diabetes Complications in the Northeastern United States: The Role of Socioeconomic Status |
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Affiliation: | 1. US Army, Tripler Army Medical Center, Honolulu, Hawaii;2. Schools of Nursing Departments of Epidemiology, and Health Policy and Management;3. Health Policy and Management, University of North Carolina at Chapel Hill;4. Gillings School of Global Public Health, Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill;5. Division of Urology, Department of Surgery, University of North Carolina at Chapel Hill;6. Department of Urology, Roswell Park Cancer Institute, Buffalo, New York;7. Department of Urology, University of Buffalo School of Medicine and Biotechnology, New York |
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Abstract: | The role of socioeconomic status (SES) in explaining racial/ethnic disparities in diabetes remains unclear. We investigated disparities in self-reported diabetes complications and the role of macro (eg, income, education) and micro (eg, owning a home or having a checking account) SES indicators in explaining these differences. The sample included individuals with a diagnosis of diabetes (N = 795) who were aged, on average, 55 years, and 55.6% non-Hispanic white, 25.0% African American, and 19.4% Hispanic. Approximately 8% reported nephropathy, 35% reported retinopathy, and 16% reported cardiovascular disease. There were significant disparities in the rates of complications among non-Hispanic white, African American, and Hispanic participants, with Hispanic participants having the highest rates of nephropathy, retinopathy, and cardiovascular disease. Macro SES indicators (eg, income) mediated racial differences (ie, non-Hispanic whites vs African Americans) in self-reported retinopathy, a combination of macro and more micro SES indicators (eg, education, income, and owning a home or having a checking account) mediated racial/ethnic differences (ie, non-Hispanic white vs Hispanic participants) in self-reported cardiovascular disease, and only micro SES indicators (eg, owning a home or having a checking account) mediated differences between lower-income SES racial/ethnic minority groups (ie, African American vs Hispanic participants) in self-reported retinopathy and cardiovascular disease. Findings underscore that indicators of SES must be sensitive to the outcome of interest and the racial/ethnic groups being compared. |
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