title: Racial and Ethnic Heterogeneity in Self-Reported Diabetes Prevalence Trends Across Hispanic Subgroups, National Health Interview Survey, 1997-2012.
abstract: BACKGROUND
  We examined racial/ethnic heterogeneity in self-reported diabetes prevalence over 15 years.
  
  
  METHODS
  We used National Health Interview Survey data for 1997 through 2012 on 452,845 adults aged 18 years or older. Annual self-reported diabetes prevalence was estimated by race/ethnicity and education. We tested for trends over time by education and race/ethnicity. We also analyzed racial/ethnic and education trends in average annual prevalence.
  
  
  RESULTS
  During the 15 years studied, diabetes prevalence differed significantly by race/ethnicity (P < .001) and by Hispanic subgroup (P < .001). Among participants with less than a high school education, the 5-year trend in diabetes prevalence was highest among Cubans and Cuban Americans (β(5YR) = 4.8, P = .002), Puerto Ricans (β(5YR) = 2.2, P = .06), non-Hispanic blacks (β(5YR) = 2.2, P < .001), and non-Hispanic whites (β(5YR) = 2.1, P < .001). Among participants with more than a high school education, non-Hispanic blacks had the highest average annual prevalence (5.5%) and Puerto Ricans had the highest 5-year trend in annual diabetes prevalence (β(5YR) = 2.6, P = .001).
  
  
  CONCLUSIONS
  In this representative sample of US adults, results show ethnic variations in diabetes prevalence. The prevalence of diabetes is higher among Hispanics than among non-Hispanic whites, unevenly distributed across Hispanic subgroups, and more pronounced over time and by education. Findings support disaggregation of data for racial/ethnic populations in the United States to monitor trends in diabetes disparities and the use of targeted, culturally appropriate interventions to prevent diabetes.
authors.affiliation: Health Sciences, Department of Surgery, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8100, St Louis, MO 63110. Email: arroyojohnsonc@wudosis.wustl.edu.
authors.forename: Cassandra
authors.initials: C
authors.lastname: Arroyo-Johnson
authors.affiliation: Xavier University, New Orleans, Louisiana.
authors.forename: Krista D
authors.initials: KD
authors.lastname: Mincey
authors.affiliation: Washington University in St Louis, St Louis, Missouri.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ackermann
authors.affiliation: Washington University in St Louis, St Louis, Missouri.
authors.forename: Laurel
authors.initials: L
authors.lastname: Milam
authors.affiliation: Washington University in St Louis, St Louis, Missouri.
authors.forename: Melody S
authors.initials: MS
authors.lastname: Goodman
authors.affiliation: Washington University in St Louis, St Louis, Missouri.
authors.forename: Graham A
authors.initials: GA
authors.lastname: Colditz
mesh_terms: D003920:Diabetes Mellitus / Q000453:epidemiology*; D006306:Health Surveys; D006630:Hispanic or Latino; D006801:Humans; D044469:Racial Groups; D014481:United States