scholarly journals A risk-based intervention approach to eliminate diabetes health disparities

2018 ◽  
Vol 19 (5) ◽  
pp. 518-522 ◽  
Author(s):  
Neil S. Calman ◽  
Diane Hauser ◽  
Lilli Schussler ◽  
Casey Crump
Keyword(s):  
New York ◽  
Health Disparities ◽  
Ethnic Disparities ◽  
Prevalence Ratio ◽  
Diabetes Control ◽  
Diverse Population ◽  
Patients With Diabetes ◽  
Multifaceted Interventions ◽  
Racial Ethnic

Type 2 diabetes plays a major role in racial/ethnic health disparities. We conducted the first study to examine whether multifaceted interventions targeting patients with poorly controlled diabetes (HgbA1c >9%) can reduce racial/ethnic disparities in diabetes control. Among 4595 patients with diabetes at a Federally Qualified Health Center in New York, a higher percentage of blacks (32%) and Hispanics/Latinos (32%) had poorly controlled diabetes than whites (25%) at baseline (prevalence ratio, 1.28; 95% CI, 1.14–1.43; P<0.001). After four years, this percentage was reduced in all groups (blacks, 21%; Hispanics/Latinos, 20%; whites, 20%; P<0.001 for each relative to baseline). Disparities in diabetes control also were significantly reduced (change in disparity relative to whites: blacks, P=0.03; Hispanics/Latinos, P=0.008). In this diverse population, interventions targeting patients with poorly controlled diabetes not only improved diabetes control in all racial/ethnic groups, but significantly reduced disparities. This approach warrants further testing and may help reduce disparities in other populations.

scholarly journals Relative Contributions of Socioeconomic, Local Environmental, Psychosocial, Lifestyle/Behavioral, Biophysiological, and Ancestral Factors to Racial/Ethnic Disparities in Type 2 Diabetes

Diabetes Care ◽  
2016 ◽  
Vol 39 (7) ◽  
pp. 1208-1217 ◽  
Author(s):  
Rebecca S. Piccolo ◽  
S.V. Subramanian ◽  
Neil Pearce ◽  
Jose C. Florez ◽  
John B. McKinlay
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
Racial Ethnic

scholarly journals Racial/Ethnic Disparities in Readmissions in US Hospitals: The Role of Insurance Coverage

2018 ◽  
Vol 55 ◽  
pp. 004695801877418 ◽  
Author(s):  
Jayasree Basu ◽  
Amresh Hanchate ◽  
Arlene Bierman
Keyword(s):  
New York ◽  
Lower Risk ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Ethnic Disparities ◽  
Hospital Performance ◽  
Insurance Status ◽  
Readmission Rates ◽  
Discharge Data ◽  
Racial Ethnic

We examine differences in rates of 30-day readmissions across patients by race/ethnicity and the extent to which these differences were moderated by insurance coverage. We use hospital discharge data of patients in the 18 years and above age group for 5 US states, California, Florida, Missouri, New York, and Tennessee for 2009, the latest year prior to the start of Centers for Medicare & Medicaid Services’ Hospital Compare program of public reporting of hospital performance on 30-day readmissions. We use logistic regression models by state to estimate the association between insurance status, race, and the likelihood of a readmission within 30 days of an index hospital admission for any cause. Overall in 5 states, non-Hispanic blacks had a slightly higher risk of 30-day readmissions relative to non-Hispanic whites, although this pattern varied by state and insurance coverage. We found higher readmission risk for non-Hispanic blacks, compared with non-Hispanic whites, among those covered by Medicare and private insurance, but lower risk among uninsured and similar risk among Medicaid. Hispanics had lower risk of readmissions relative to non-Hispanic whites, and this pattern was common across subgroups with private, Medicaid, and no insurance coverage. Uninsurance was associated with lower risk of readmissions among minorities but higher risk of readmissions among non-Hispanic whites relative to private insurance. The study found that risk of readmissions by racial ethnic groups varies by insurance status, with lower readmission rates among minorities who were uninsured compared with those with private insurance or Medicare, suggesting that lower readmission rates may not always be construed as a good outcome, because it could result from a lack of insurance coverage and poor access to care, particularly among the minorities.

scholarly journals Racial/Ethnic Disparities at the End of an HIV Epidemic: Persons Who Inject Drugs in New York City, 2011–2015

2017 ◽  
Vol 107 (7) ◽  
pp. 1157-1163 ◽  
Author(s):  
Don C. Des Jarlais ◽  
Kamyar Arasteh ◽  
Courtney McKnight ◽  
Jonathan Feelemyer ◽  
Susan Tross ◽  
...  
Keyword(s):  
New York ◽  
New York City ◽  
York City ◽  
Ethnic Disparities ◽  
Persons Who Inject Drugs ◽  
Hiv Epidemic ◽  
Racial Ethnic

scholarly journals Racial and Ethnic Disparities in Health

2019 ◽  
Author(s):  
Samia Tasmim ◽  
Sarah Collins
Keyword(s):  
Health Disparities ◽  
Healthcare Access ◽  
Ethnic Disparities ◽  
Well Being ◽  
Racial And Ethnic Disparities ◽  
Individual Level ◽  
Fundamental Cause ◽  
Race Ethnicity ◽  
Unequal Opportunities ◽  
Racial Ethnic

Racial and ethnic disparities in health stem from the historical legacy and continued patterns of unequal resources and treatment on the basis of race/ethnicity in society (Hummer and Hamilton 2019; Williams and Sternthal 2010). Health disparities encompass differences in physical health, mental health, all-cause and cause-specific mortality risk, activity limitations, healthcare access and utilization, and other metrics of well-being. Researchers have identified a variety of explanations for racial/ethnic health disparities, including socioeconomic inequality, institutional- and individual-level discrimination, residential segregation, early-life circumstances, and health behaviors, among others. However, unequal opportunities on the basis of race/ethnicity remain the fundamental cause of health disparities (Hummer 1996; Phelan and Link 2015).

scholarly journals Diabetes Mellitus and the Risk for Developing Cancer

2013 ◽  
Vol 2 (1) ◽  
pp. 41-43
Author(s):  
Shane Malachy Markey ◽  
Marie A Congiusta
Keyword(s):  
Physical Activity ◽  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
New York ◽  
Research Evidence ◽  
New York University ◽  
Contributing Factors ◽  
The World ◽  
Patients With Diabetes

ABSTRACT Diabetes mellitus is a serious and growing health care problem, globally. The ‘westernization’ of diets around the world has led to an increase in obesity. Other contributing factors such as smoking, lack of physical activity and aging has led to epidemiological concerns regarding the link between diabetes and cancer. Research evidence suggests that patients with diabetes may be at greater risk for the development of some forms of cancer. The patient being discussed in this case report presented to New York University College of Dentistry (NYUCD), with a history that included type 2 diabetes mellitus, seeking comprehensive dental care. During the interim between his initial exam and following appointment, a lesion had developed on the palate, which was subsequently diagnosed as adenocarcinoma. This prompted the review of current literature, regarding the link between diabetes and the development of various cancers. How to cite this article Markey SM, Congiusta MA. Diabetes Mellitus and the Risk for Developing Cancer. Int J Experiment Dent Sci 2013;2(1):41-43.

scholarly journals Racial and Ethnic Disparities in Comorbidities in Youth With Type 2 Diabetes in the Pediatric Diabetes Consortium (PDC)

2021 ◽  
Author(s):  
Fida Bacha ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Lindsey C. Beaulieu ◽  
Craig Kollman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Alcoholic Fatty Liver ◽  
Pediatric Diabetes ◽  
Significant Difference ◽  
Racial Ethnic ◽  
Hispanic White

<p><b>Background: </b>Type 2 diabetes in the United States is more prevalent in youth of minority racial-ethnic background but disparities in health outcomes have not be examined in this population. </p> <p><b>Methods: </b>We examined racial-ethnic differences in the initial presentation and subsequent comorbidities in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes Consortium (PDC) Registry from February 2012 to June 2018. Demographic and clinical data were collected from medical records and participant self-report. </p> <p><b>Results: </b>Overall, the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>. HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry participants with no significant difference among racial-ethnic groups. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in NHB.</p> <p><b>Conclusion: </b>NHB and H youth with type 2 diabetes presented with worse metabolic control and had persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in a large percentage of these youth independent of race-ethnicity, except for NAFLD being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic disparities at diagnosis and in the management of youth with type 2 diabetes. </p>

scholarly journals Racial and Ethnic Disparities in Comorbidities in Youth With Type 2 Diabetes in the Pediatric Diabetes Consortium (PDC)

2021 ◽  
Author(s):  
Fida Bacha ◽  
Peiyao Cheng ◽  
Robin L. Gal ◽  
Lindsey C. Beaulieu ◽  
Craig Kollman ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Ethnic Disparities ◽  
The United States ◽  
Self Report ◽  
Alcoholic Fatty Liver ◽  
Pediatric Diabetes ◽  
Significant Difference ◽  
Racial Ethnic ◽  
Hispanic White

<p><b>Background: </b>Type 2 diabetes in the United States is more prevalent in youth of minority racial-ethnic background but disparities in health outcomes have not be examined in this population. </p> <p><b>Methods: </b>We examined racial-ethnic differences in the initial presentation and subsequent comorbidities in youth with type 2 diabetes (N=1217, 63% females) enrolled in the Pediatric Diabetes Consortium (PDC) Registry from February 2012 to June 2018. Demographic and clinical data were collected from medical records and participant self-report. </p> <p><b>Results: </b>Overall, the mean age at presentation was 13.4 ± 2.4 years, BMI was 35.0 (9.4) kg/m<sup>2</sup>. HbA1c was higher and C-peptide was lower in Non-Hispanic Black (NHB) and Hispanic (H) youth compared to Non-Hispanic White (NHW) youth. NHB were 3 times as likely to present in DKA (19%) vs. NHW (6.3%) and H (7.5%) and both NHB and H had a worse HbA1c trajectory compared with NHW peers. Microalbuminuria was documented in 11%, hypertension in 34% and dyslipidemia in 42% of Registry participants with no significant difference among racial-ethnic groups. Non-alcoholic fatty liver disease (NAFLD) was diagnosed in 9% and 11% of H and NHW, respectively vs. 2% in NHB.</p> <p><b>Conclusion: </b>NHB and H youth with type 2 diabetes presented with worse metabolic control and had persistently worse HbA1c trajectories compared with NHW. Comorbidities exist in a large percentage of these youth independent of race-ethnicity, except for NAFLD being less prevalent in NHB. Greater efforts are needed to mitigate racial-ethnic disparities at diagnosis and in the management of youth with type 2 diabetes. </p>

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