The impact of access to health services on prediabetes awareness: A population-based study.
Research demonstrates that prediabetes awareness has important implications for participation in diabetes risk-reducing behaviors. We examined the impact of levels of access to health services on prediabetes awareness. In 2016, we conducted an analysis among U.S. adults with prediabetes using cross-sectional data from three cycles (2007-2008, 2009-2010, and 2011-2012) of the National Health and Nutrition Examination Survey. Participants aware and unaware of their prediabetes were classified as having full, partial, or no access to health services based on current health insurance coverage and having a routine place to go for health care. Multivariable logistic regression was used to estimate the association between access to health services and prediabetes awareness. Among a total sample of 2999U.S. adults with prediabetes, an estimated 92.0% were unaware of their prediabetes status. Participants that were unaware of their prediabetes tended to be younger, male, and were less likely to be obese or have a family history of diabetes. Having no access to health services significantly increased the odds of being prediabetes unaware (AOR: 2.65; 95% CI: 1.10-6.38). However, participants with insurance but no place of regular care had the greatest odds of being prediabetes unaware (AOR: 3.21; 95% CI: 1.21-8.55). These findings suggest that access to health services is a key factor for prediabetes awareness. Health policies and interventions should strive to ensure equitable access to health services in order to detect prediabetes, and promote awareness and engagement in risk-reducing behaviors to decrease the incidence of diabetes.
Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada. Electronic address: tonya.campbell@mail.utoronto.ca.
Tonya J
TJ
Campbell
Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue G1 06, Toronto, ON, M4N 3M5, Canada. Electronic address: amanda.alberga@ices.on.ca.
Amanda
A
Alberga
Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON, M5T 3M7, Canada; Institute for Clinical Evaluative Sciences, 2075 Bayview Avenue G1 06, Toronto, ON, M4N 3M5, Canada; Public Health Ontario, 480 University Ave #300, Toronto, ON, M5G 1V2, Canada. Electronic address: laura.rosella@utoronto.ca.
Laura C
LC
Rosella
D000367:Age Factors; D001364:Awareness; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000517:prevention & control; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health; D009749:Nutrition Surveys; D011236:Prediabetic State / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D014481:United States
Diabetes; Health care access; Health insurance; Health services; Prediabetes; Prevention