Environmental and socio-economic factors as contributors to racial disparities in diabetes prevalence.
BACKGROUND
We deployed a study design that attempts to account for racial differences in socioeconomic and environmental risk exposures to determine if the diabetes race disparity reported in national data is similar when black and white Americans live under similar social conditions.


METHODS
We compared data from the 2003 National Health Interview Survey (NHIS) with the Exploring Health Disparities in Integrated Communities-Southwest Baltimore (EHDIC-SWB) Study, which was conducted in a racially-integrated urban community without race differences in socioeconomic status.


RESULTS
In the NHIS, African Americans had greater adjusted odds of having diabetes compared to whites (OR: 1.61, 95% CI: 1.26-2.04); whereas, in EHDIC-SWB white and African Americans had similar odds of having diabetes (OR: 1.07, 95% CI: 0.71-1.58). Diabetes prevalence for African Americans was similar in NHIS and EHDIC-SWB (10.4%, 95%CI: 9.5-11.4 and 10.5%, 95%CI: 8.5-12.5, respectively). Diabetes prevalence among whites differed for NHIS (6.6%, 95%CI: 6.2-6.9%) and EHDIC-SWB (10.1%, 95%CI: 7.6-12.5%).


CONCLUSIONS
Race disparities in diabetes may stem from differences in the health risk environments that African Americans and whites live. When African Americans and whites live in similar risk environments, their health outcomes are more similar.
LaVeist
Thomas A
TA
Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA. tlaveist@jhsph.edu
Thorpe
Roland J
RJ
Galarraga
Jessica E
JE
Bower
Kelly M
KM
Gary-Webb
Tiffany L
TL
D000328:Adult; D044383:Black People / Q000208:ethnology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000191:economics* / Q000453:epidemiology*; D004777:Environment; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D044469:Racial Groups / Q000208:ethnology; D012959:Socioeconomic Factors; D044465:White People / Q000208:ethnology*; D001741:Black or African American
Health Aff (Millwood). 2008 Mar-Apr;27(2):518-27
18332510
J Urban Health. 2008 Jan;85(1):11-21
17999196
JAMA. 2001 Sep 12;286(10):1195-200
11559264
Am J Prev Med. 2004 Oct;27(3 Suppl):154-62
15450626
Health Serv Res. 2003 Dec;38(6 Pt 2):1719-33
14727794
Addiction. 2007 Oct;102 Suppl 2:65-70
17850615
Soc Sci Med. 2000 Aug;51(4):613-7
10868674
Arch Intern Med. 2008 Jun 9;168(11):1145-51
18541821
Lancet. 1990 Nov 17;336(8725):1238-40
1978083
J Clin Epidemiol. 2003 Feb;56(2):148-54
12654409
Public Health Rep. 2001 Sep-Oct;116(5):404-16
12042604
MMWR Morb Mortal Wkly Rep. 2005 Jan 14;54(1):1-3
15647722
J Epidemiol Community Health. 2003 Jan;57(1):29-35
12490645
Soc Sci Med. 1998 Jun;46(12):1519-29
9672392
J Natl Med Assoc. 2009 Jan;101(1):18-23
19245068
Ethn Dis. 2009 Winter;19(1):49-55
19341163
Pediatrics. 2006 Feb;117(2):417-24
16452361
J Urban Health. 2005 Jun;82(2 Suppl 3):iii26-34
15933328
Ethn Dis. 2004 Summer;14(3 Suppl 1):S38-45
15682770
Health Educ Behav. 1999 Aug;26(4):535-46
10435236
J Nurs Meas. 2004 Winter;12(3):235-47
16138727
Diabet Med. 2003 Nov;20(11):921-9
14632718