title: Exploring ethnic disparities in diabetes, diabetes care, and lifestyle behaviors: the Nashville REACH 2010 community baseline survey.
abstract: In order to gain a better understanding of diabetes-related health disparities, Nashville REACH 2010 conducted a community baseline survey on health status. A total of 3204 randomly selected African-American (AA) and Caucasian (C) residents of North Nashville, and a comparison sample of residents living in Nashville/Davidson County were interviewed using a computer-assisted telephone interviewing system. Diabetes prevalence was determined, and similarities/differences relative to access to health care, co-morbid conditions, diabetes care, and lifestyle behaviors, were examined. Age-adjusted prevalence of diabetes was 1.7 times higher among AAs. Increasing age (P<.0001) and being AA (P<.01) were predictive of diabetes status in a regression model. African Americans were more likely to be uninsured (P<.01), while Cs had to travel farther to get medical care (P<.0002). Compared to Caucasians, African Americans were 1.6 times more likely to have co-morbid hypertension (P<.004). Reported insulin use was higher (P<.0001) in AAs, and more Cs (25.5% vs 9.1%, respectively) reported taking no medications. African Americans were more likely to report (P<.0001) daily glucose self-monitoring, while more Cs (P<.04) reported having had an eye exam in the last 1 to 2 years. Caucasians reported more (P<.05) active lifestyle behaviors, while AA reported more (P<.001) fat-increasing behaviors. In conclusion, interventions addressing diabetes disparities in the target population should focus on insuring equitable awareness of, and access to, insurance options; managing co-morbidities; improving provider adherence to standards of care; and establishing multi-level supports for lifestyle modifications.
authors.affiliation: Department of Surgery, Meharry Medical College, Nashville, Tennessee 37208, USA. smiller@mmc.edu
authors.forename: Stephania T
authors.initials: ST
authors.lastname: Miller
authors.forename: David G
authors.initials: DG
authors.lastname: Schlundt
authors.forename: Celia
authors.initials: C
authors.lastname: Larson
authors.forename: Ronald
authors.initials: R
authors.lastname: Reid
authors.forename: James W
authors.initials: JW
authors.lastname: Pichert
authors.forename: Margaret
authors.initials: M
authors.lastname: Hargreaves
authors.forename: Anne
authors.initials: A
authors.lastname: Brown
authors.forename: Linda
authors.initials: L
authors.lastname: McClellan
authors.forename: Michelle
authors.initials: M
authors.lastname: Marrs
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D018672:Community Health Planning / Q000458:organization & administration*; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000517:prevention & control*; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006305:Health Status Indicators; D040361:Healthy People Programs; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D013714:Tennessee / Q000453:epidemiology; D044465:White People