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.
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.
Robbins
J M
JM
Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6298, USA. Jessica_Robbins@pop.upenn.edu
Vaccarino
V
V
Zhang
H
H
Kasl
S V
SV
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