title: Racial and ethnic disparities in healthcare use, delayed care, and management of diabetes mellitus in older adults in California.
abstract: This study examined racial and ethnic differences in healthcare use, delayed care, and management of care of older adults with a self-reported diagnosis of diabetes mellitus. Drawing on the 2009 California Health Interview Survey (CHIS), the sample included 3,003 adults (representative of N = 998,795) aged 60 and older from five racial and ethnic groups: non-Hispanic white (n = 2,153), African American (n = 213), Hispanic (n = 336), Asian (n = 306), and American Indian and Alaska Native (AI/AN) (n = 59). All self-reported a diagnosis of diabetes mellitus. Descriptive statistics and logistic regression analyses were conducted using weighted data. Results from adjusted logistic regressions indicated significant racial and ethnic differences between non-Hispanic white elderly and the other groups examined. Specifically, African Americans were significantly less likely than whites to see a doctor and to have a usual source of care, and were more likely to visit the emergency department (ED) for diabetes mellitus and to have their feet examined by a provider. Hispanics were significantly less likely to take medicine to lower cholesterol but were more likely to test their blood glucose regularly (following ADA guidelines). Asians were significantly less likely than whites to test their blood glucose regularly or have a foot examination. AI/ANs were significantly less likely than whites to see a doctor, visit an ED, and take medication to reduce heart attack risk but were more likely to use insulin, oral diabetic medication, or both. The findings suggest the need for racial- and ethnic-specific interventions for managing diabetes mellitus to help reduce existing racial and ethnic disparities among elderly adults.
authors.affiliation: Center for Mental Health and Aging, University of Alabama, Tuscaloosa, Alabama 35487, USA. Giyeon.Kim@ua.edu
authors.forename: Giyeon
authors.initials: G
authors.lastname: Kim
authors.forename: Katy L
authors.initials: KL
authors.lastname: Ford
authors.forename: David A
authors.initials: DA
authors.lastname: Chiriboga
authors.forename: Dara H
authors.initials: DH
authors.lastname: Sorkin
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D001786:Blood Glucose / Q000032:analysis; D002140:California; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000188:drug therapy / Q000208:ethnology*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006306:Health Surveys; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D010349:Patient Compliance / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents