title: Excess type 2 diabetes in African-American women and men aged 40-74 and socioeconomic status: evidence from the Third National Health and Nutrition Examination Survey.
abstract: OBJECTIVE
  To examine whether socioeconomic status (SES) explains differences in the prevalence of type 2 diabetes between African-American and non-Hispanic white women and men.
  
  
  METHODS
  Cross sectional study of diabetes prevalence, SES, and other risk factors ascertained by physical examination and interview.
  
  
  METHODS
  Interviews were conducted in subjects' homes; physical examinations were conducted in mobile examination centres.
  
  
  METHODS
  961 African-American women, 1641 non-Hispanic white women, 839 African-American men and 1537 non-Hispanic white men, aged 40 to 74 years, examined in the Third National Health and Nutrition Examination Survey (NHANES III), a representative sample of the non-institutionalised civilian population of the United States, 1988-1994.
  
  
  RESULTS
  Among women, African-American race/ethnicity was associated with an age adjusted odds ratio of 1.76 (95% confidence intervals 1.21, 2.57), which was reduced to 1.42 (95% confidence intervals 0.95, 2.13) when poverty income ratio was controlled. Controlling for education or occupational status had minimal effects on this association. When other risk factors were controlled, race/ethnicity was not significantly associated with type 2 diabetes prevalence. Among men, the age adjusted odds ratio associated with African-American race/ethnicity was 1.43 (95% confidence intervals 1.03, 1.99). Controlling for SES variables only modestly affected the odds ratio for African/American race/ethnicity among men, while adjusting for other risk factors increased the racial/ethnic differences.
  
  
  CONCLUSIONS
  Economic disadvantage may explain much of the excess prevalence of type 2 diabetes among African-American women, but not among men.
authors.affiliation: Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6298, USA. Jessica_Robbins@pop.upenn.edu
authors.forename: J M
authors.initials: JM
authors.lastname: Robbins
authors.forename: V
authors.initials: V
authors.lastname: Vaccarino
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: S V
authors.initials: SV
authors.lastname: Kasl
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D016017:Odds Ratio; D015995:Prevalence; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data