Racial Differences in Health Status Among Newly Diagnosed Type 2 Diabetes
Author(s)
Wen Hsin Chen, BSc, MSc, MSPH, RN;
Pharmacy Systems Outcomes and Policy, HEOR fellow, Chicago, IL, USA
Pharmacy Systems Outcomes and Policy, HEOR fellow, Chicago, IL, USA
Presentation Documents
OBJECTIVES: To investigate racial disparities in health status, management, and outcome among U.S. adults with newly diagnosed with diabetes.
METHODS: We analyzed the National Health and Nutrition Examination Survey spanning 1999-2020, including 1,522 non-pregnant adults over 19 years recently diagnosed with diabetes, within the past 2-years. We estimated age- and sex-standardized rates by race/ethnicity. We estimated regression models adjusting for demographic (age, gender, education, BMI), socioeconomic (family income), health behavior (smoking status) and access to care factors (usual source of care and health insurance). Outcomes included hypertension (>140/90 mmHg or medication use), hyperlipidemia (total cholesterol ≥240 mg/dL), chronic kidney disease (CKD; albumin-to-creatinine ratio ≥30 mg/g or eGFR <60 mL/min/1.73 m²), and cardiovascular events (CVD). Disease management was defined as achieving HbA1c <7.0%, blood pressure <140/90 mmHg, or cholesterol <240 mg/dL.
RESULTS: Before standardization, White participants were older (50% aged ≥65 years vs. 30% Black, 33% Mexican, 36% other) and 6% more likely to be male. After age/gender standardization, we observed significant racial disparities. Black individuals had lower HbA1c control rates than White individuals (76.96% vs. 84.67%, p=0.024) and higher hypertension prevalence (60.8% vs. 46.75%, p<0.001) despite better hyperlipidemia treatment (50.66% vs. 43.09%, p<0.001) and control (17.98% vs. 16.22%, p<0.001). Mexican Americans had the lowest CVD rates (11.03%) compared to Whites (21.58%), Blacks (23.95%), and others (17.69%, p=0.012). CKD rates showed no significant differences. Adjusting for age, gender, socioeconomic, and clinical factors may either amplify or diminish disparities, depending on the heterogeneous nature of the racial population characteristics.
CONCLUSIONS: Racial disparities persist among individuals with newly diagnosed diabetes. Black individuals face challenges in hypertension and HbA1c control despite higher treatment rates, while Mexican Americans demonstrate the lowest cardiovascular event rates. Addressing these disparities requires targeted, population-specific strategies to promote equity and improve health outcomes across racial groups.
METHODS: We analyzed the National Health and Nutrition Examination Survey spanning 1999-2020, including 1,522 non-pregnant adults over 19 years recently diagnosed with diabetes, within the past 2-years. We estimated age- and sex-standardized rates by race/ethnicity. We estimated regression models adjusting for demographic (age, gender, education, BMI), socioeconomic (family income), health behavior (smoking status) and access to care factors (usual source of care and health insurance). Outcomes included hypertension (>140/90 mmHg or medication use), hyperlipidemia (total cholesterol ≥240 mg/dL), chronic kidney disease (CKD; albumin-to-creatinine ratio ≥30 mg/g or eGFR <60 mL/min/1.73 m²), and cardiovascular events (CVD). Disease management was defined as achieving HbA1c <7.0%, blood pressure <140/90 mmHg, or cholesterol <240 mg/dL.
RESULTS: Before standardization, White participants were older (50% aged ≥65 years vs. 30% Black, 33% Mexican, 36% other) and 6% more likely to be male. After age/gender standardization, we observed significant racial disparities. Black individuals had lower HbA1c control rates than White individuals (76.96% vs. 84.67%, p=0.024) and higher hypertension prevalence (60.8% vs. 46.75%, p<0.001) despite better hyperlipidemia treatment (50.66% vs. 43.09%, p<0.001) and control (17.98% vs. 16.22%, p<0.001). Mexican Americans had the lowest CVD rates (11.03%) compared to Whites (21.58%), Blacks (23.95%), and others (17.69%, p=0.012). CKD rates showed no significant differences. Adjusting for age, gender, socioeconomic, and clinical factors may either amplify or diminish disparities, depending on the heterogeneous nature of the racial population characteristics.
CONCLUSIONS: Racial disparities persist among individuals with newly diagnosed diabetes. Black individuals face challenges in hypertension and HbA1c control despite higher treatment rates, while Mexican Americans demonstrate the lowest cardiovascular event rates. Addressing these disparities requires targeted, population-specific strategies to promote equity and improve health outcomes across racial groups.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EPH154
Topic
Epidemiology & Public Health
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Neurological Disorders, SDC: Urinary/Kidney Disorders