title: Racial/Ethnic Differences in Use of Health Care Services for Diabetes Management.
abstract: Research demonstrates consistent racial/ethnic disparities in access to and use of health care services for a variety of chronic conditions. Yet we know little about whether these disparities exist for use of health care services for diabetes management. Racial/ethnic minorities disproportionately suffer from diabetes, complications from diabetes, and diabetes-related mortality. Proper diabetes management can reduce the risk of complications and premature mortality. Using a large national data set (N = 37,705) of White, Black, Hispanic, Asian, and Native American U.S. adults aged 65 years and older who have been diagnosed with diabetes, we examine three specific types of health care provider (HCP) use for diabetes management: number of times seen by a health care professional for diabetes, number of times feet have been checked by a health care professional, and number of visits for a glycosylated hemoglobin check. We found that net of controls for a variety of demographic and socioeconomic characteristics, Blacks and Hispanics had significantly more visits to a HCP for their diabetes and significantly more glycosylated hemoglobin checks than Whites, and Blacks and Native Americans had significantly more HCP feet checks than Whites. Our results suggest that the reduced access to health care services traditionally found among racial/ethnic minorities does not hold for access to health care services for diabetes management, where racial/ethnic minority diabetics are actually more likely to use care than are White diabetics. Future research should examine whether higher use of health care services for diabetes among racial/ethnic minorities is due to greater disease severity among racial/ethnic minorities than among non-Hispanic Whites.
authors.affiliation: Pennsylvania State University, University Park, PA, USA.
authors.forename: Raeven Faye
authors.initials: RF
authors.lastname: Chandler
authors.affiliation: Pennsylvania State University, University Park, PA, USA smm67@psu.edu.
authors.forename: Shannon M
authors.initials: SM
authors.lastname: Monnat
mesh_terms: D000368:Aged; D001213:Asian / Q000706:statistics & numerical data; D044383:Black People / Q000706:statistics & numerical data; D002908:Chronic Disease; D003920:Diabetes Mellitus / Q000208:ethnology* / Q000628:therapy; D019468:Disease Management; D005260:Female; D015438:Health Behavior / Q000208:ethnology; D006296:Health Services / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
keywords: chronic disease management; diabetes; health behavior; race/ethnicity; social inequalities
references.citation: Am J Public Health. 2003 Dec;93(12):2074-8
references.pmid: 14652337
references.citation: N Engl J Med. 1999 Oct 14;341(16):1198-205
references.pmid: 10519898
references.citation: Med Clin North Am. 2005 Sep;89(5):949-75, viii
references.pmid: 16129107
references.citation: Diabetes Care. 2013 May;36(5):1147-52
references.pmid: 23230095
references.citation: Diabetes Care. 2001 Jun;24(6):979-82
references.pmid: 11375356
references.citation: Diabetes Care. 1998 Apr;21(4):518-24
references.pmid: 9571335
references.citation: Diabetes Care. 1993 Aug;16(8):1116-23
references.pmid: 8375241
references.citation: Health Serv Res. 1998 Aug;33(3 Pt 1):571-96
references.pmid: 9685123
references.citation: N Engl J Med. 1989 Oct 19;321(16):1074-9
references.pmid: 2797067
references.citation: Cancer Causes Control. 2005 Feb;16(1):35-44
references.pmid: 15750856
references.citation: Am J Public Health. 2004 Jan;94(1):66-70
references.pmid: 14713700
references.citation: Am J Prev Med. 2005 Dec;29(5):412-20
references.pmid: 16376704
references.citation: J Diabetes Complications. 2009 Mar-Apr;23(2):112-8
references.pmid: 18413179
references.citation: Med Care Res Rev. 2000;57 Suppl 1:36-54
references.pmid: 11092157
references.citation: Am J Public Health. 2009 Jul;99(7):1293-9
references.pmid: 18923129
references.citation: Med Care Res Rev. 2000;57 Suppl 1:108-45
references.pmid: 11092160
references.citation: Diabetes Care. 2013 Jan;36 Suppl 1:S11-66
references.pmid: 23264422
references.citation: J Community Health. 2007 Feb;32(1):5-20
references.pmid: 17269310
references.citation: Diabetes Care. 2003 Dec;26(12):3250-6
references.pmid: 14633810
references.citation: JAMA. 2002 May 15;287(19):2519-27
references.pmid: 12020332
references.citation: J Gen Intern Med. 2002 Jun;17(6):458-64
references.pmid: 12133161
references.citation: J Health Soc Behav. 1995 Mar;36(1):1-10
references.pmid: 7738325
references.citation: J Health Care Poor Underserved. 2014 Feb;25(1):332-56
references.pmid: 24509030
references.citation: Arch Intern Med. 2004 Sep 27;164(17):1858-64
references.pmid: 15451760
references.citation: Diabetes Care. 1997 Jun;20(6):971-7
references.pmid: 9167108
references.citation: Milbank Mem Fund Q Health Soc. 1973 Winter;51(1):95-124
references.pmid: 4198894
references.citation: J Gen Intern Med. 2007 Jan;22(1):115-20
references.pmid: 17351850
references.citation: Diabetes Educ. 2004 Jul-Aug;30(4):665-75
references.pmid: 15669782
references.citation: Med Care. 2003 Nov;41(11):1221-32
references.pmid: 14583685
references.citation: Diabetes Care. 2000 Apr;23(4):477-83
references.pmid: 10857938
references.citation: Diabetes Care. 1999 Mar;22(3):403-8
references.pmid: 10097918
references.citation: Prev Chronic Dis. 2006 Jul;3(3):A85
references.pmid: 16776886
references.citation: Prim Care Diabetes. 2008 Feb;2(1):39-44
references.pmid: 18684419