Using multiple sources of data to assess the prevalence of diabetes at the subcounty level, Duval County, Florida, 2007.
BACKGROUND
Diabetes rates continue to grow in the United States. Effectively addressing the epidemic requires better understanding of the distribution of disease and the geographic clustering of factors that influence it. Variations in the prevalence of diabetes at the local level are largely unreported, making understanding the disparities associated with the disease more difficult. Diabetes death rates during the past 15 years in Duval County, Florida, have been disproportionately high compared with the rest of the state.


METHODS
We analyzed multiple sources of secondary data related to diabetes illness and death in Duval County, including data on hospital discharge, emergency department (ED) use, and vital statistics. We accessed diabetes and diabetes-related ED use and hospitalization and death data by using codes from the International Classification of Diseases versions 9 and 10. We analyzed data from the Behavioral Risk Factor Surveillance System survey for Duval County and adapted Centers for Disease Control and Prevention weighting formulas for subcounty analysis. We used relative risk-type disease ratios and geographic information systems mapping to analyze data.


RESULTS
The urban, mostly minority, low-socioeconomic area of Duval County had twice the rate of diabetes-related illness and death as other areas of the county, and the inner-city, poor area of the county had almost 3 times the rate of hospitalization and ED use for diabetes and diabetes-related conditions compared with the other areas of the county.


CONCLUSIONS
Our analyses show that diabetes-related disparities affect not only people and their families but also the community that absorbs the costs associated with the disproportionate health care use that results from these disparities. Analyzing data at the subcounty level has implications for health care planning and public health policy development at the local level.
Livingood
William C
WC
Duval County Health Department and University of Florida College of Medicine, Jacksonville, FL 32211, USA. William_Livingood@doh.state.fl.us
Razaila
Luminita
L
Reuter
Elena
E
Filipowicz
Rebecca
R
Butterfield
Ryan C
RC
Lukens-Bull
Katryne
K
Edwards
Linda
L
Palacio
Carlos
C
Wood
David L
DL
D040343:Behavioral Risk Factor Surveillance System; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005191:Family Characteristics; D005431:Florida / Q000453:epidemiology; D017048:Health Care Costs; D054625:Healthcare Disparities; D006760:Hospitalization / Q000191:economics; D006801:Humans; D008913:Minority Groups; D012959:Socioeconomic Factors