Lyndsay A. Nelson|Michael T. Ackerman|Robert A. Greevy|Kenneth A. Wallston|Lindsay S. Mayberry
Beyond Race Disparities: Accounting for Socioeconomic Status in Diabetes Self-Care
Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center|Vanderbilt University Medical Center
among patients type 2 diabetes racial disparities prevalent across variety outcomes however inconsistent disparities determinants outcomes warrants exploring impact related factors study sought examine whether disparities health literacy numeracy selfcare behaviors hba1c persisted nonhispanic blacks nonhispanic whites applying robust adjustment socioeconomic status sesfrom 2016 2018 adult patients type 2 diabetes n444 recruited primary care clinics participants selfreported demographics indicators ses ie income education health insurance housing status financial strain subjective health literacy numeracy selfcare behaviors participants also completed hba1c test 2018 differences examined nonhispanic blacks nonhispanic whites health literacy numeracy selfcare hba1c first unadjusted adjusted using propensity score weightingin unadjusted analyses compared nonhispanic whites nonhispanic blacks lower health literacy p0039 numeracy p0001 less medication adherence p0009 use information dietary decisions p0013 problem eating behaviors p0001 ie nonhispanic blacks reported fewer problems higher hba1c levels p0005 adjusting ses indicators reverse disparity problem eating behaviors p0016 disparity hba1c p0011 remainedfindings highlight importance considering ses examining disparities healthrelated skills behaviors moving beyond education income inclusion comprehensive markers ses improve understanding ses may contribute disparities ability appropriately target factors leading inequality