title: Socioeconomic status and gender affects utilization of Medical Nutrition Therapy.
abstract: OBJECTIVE
  To identify socioeconomic status and gender inequalities in long and short-term Medical Nutrition Therapy among Israeli adult patients with diabetes.
  
  
  METHODS
  An analysis of data was performed on 90,900 patients over the age of 18 who were registered as patients with diabetes mellitus in Maccabi Healthcare Service Register which is the second largest health maintenance organization in Israel. Socioeconomic Rank for each patient was determined from the Israel Central Bureau of Statistics by geographical area of residence. Medical Nutrition Therapy was defined by the number of visits with registered dietitians. Short-term therapy was defined as one visit and long term therapy as two or more visits during the previous two years. Newly diagnosed patients were compared with veteran patients.
  
  
  RESULTS
  Only 25.8% of the patients with diabetes received nutrition therapy during the previous two years. Newly diagnosed patients received therapy more frequently than veterans. We found that long term therapy was positively dependent on socioeconomic rank. Women under the age of seventy five had a higher chance of receiving therapy compared to men.
  
  
  CONCLUSIONS
  A nationwide nutritional counseling service is available and accessible to all patients with diabetes. However, the patients with higher socioeconomic rank have a higher rate of persistence with long-term nutritional therapy.
authors.affiliation: Maccabi Healthcare Services, Faculty of Social Welfare and Health Studies, University of Haifa, Israel; School of Public Health, Faculty of Social Welfare and Health Studies, University of Haifa, Israel.
authors.forename: Ronit
authors.initials: R
authors.lastname: Endevelt
authors.affiliation: School of Public Health, Faculty of Social Welfare and Health Studies, University of Haifa, Israel.
authors.forename: Orna
authors.initials: O
authors.lastname: Baron-Epel
authors.affiliation: Maccabi Healthcare Services, Faculty of Social Welfare and Health Studies, University of Haifa, Israel.
authors.forename: Anna
authors.initials: A
authors.lastname: Viner
authors.affiliation: Maccabi Healthcare Services, Faculty of Social Welfare and Health Studies, University of Haifa, Israel; Department of Family Medicine, Sackler Faculty of Medicine, Tel Aviv University, Israel. Electronic address: tonyheymann@gmail.com.
authors.forename: Anthony David
authors.initials: AD
authors.lastname: Heymann
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003376:Counseling; D003920:Diabetes Mellitus / Q000178:diet therapy*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel; D008297:Male; D008875:Middle Aged; D044623:Nutrition Therapy / Q000706:statistics & numerical data*; D012737:Sex Factors; D012923:Social Class; D012959:Socioeconomic Factors; D014728:Veterans; D055815:Young Adult