title: Health disparities among youth with type 1 diabetes: A systematic review of the current literature.
abstract: BACKGROUND
  Research in pediatric Type 1 diabetes (T1D) has reliably identified differences in health outcomes based on race/ethnicity and socioeconomic status (SES). Racial/ethnic minority and/or low-SES youth consistently display poorer physical health and psychological functioning than racial/ethnic majority and higher-SES youth. The purpose of this review is to better understand health disparities in T1D by race/ethnicity and SES, and to provide recommendations for researchers based on these findings.
  
  
  METHODS
  Articles were obtained from PsycINFO, PubMed, and Web of Knowledge with search terms: "Type 1 diabetes," "ethnic," "pediatric," "race/ethnicity," "race," "socioeconomic status," "SES," and "income." Criteria for inclusion were (a) Type 1 diabetes cases, (b) child or adolescent samples, (c) information about health or psychosocial outcomes grouped by race/ethnicity or SES, (d) no intervention data, (e) peer-reviewed, (f), English-language, and (g) published in an academic journal.
  
  
  RESULTS
  Twenty-seven articles reported on health outcomes and 4 articles reported on psychosocial outcomes. Across 16 studies, racial/ethnic minority youth displayed higher HbA1c levels compared to Caucasian youth. Eighteen studies reported that lower-SES youth had higher HbA1c levels than higher-SES youth. Four studies found racial/ethnic minority youth and lower-SES youth had poorer psychological functioning than Caucasian youth or higher-SES youth.
  
  
  CONCLUSIONS
  Findings from our review suggest an association between race/ethnicity, SES, and health outcomes in pediatric T1D. Researchers should consider developing interventions that take into account factors which may place children from racial/ethnic minority and lower-SES backgrounds at risk for poor metabolic control and emotional functioning. Future research should examine causative mechanisms of health disparities.
authors.affiliation: Department of Psychology.
authors.forename: Adrienne P
authors.initials: AP
authors.lastname: Borschuk
authors.affiliation: Department of Psychology.
authors.forename: Robin S
authors.initials: RS
authors.lastname: Everhart
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000191:economics* / Q000628:therapy; D006304:Health Status; D054625:Healthcare Disparities; D006801:Humans; D010372:Pediatrics / Q000191:economics / Q000592:standards*; D012923:Social Class; D055815:Young Adult