Analysis Shows Minorities Less Likely to Receive “Cornerstone” Diabetes Test
February 12, 2010 (Newswise) - Ethnic and racial minorities bear a disproportionate share of America’s diabetes epidemic but are significantly less likely than whites to receive a commonly used test to monitor control of blood glucose, according to Washington State University researchers.
In a commentary for the current issue of The Diabetes Educator, Assistant Professor of Pharmacotherapy Joshua Jon Neumiller and colleagues document how black and Hispanic patients diagnosed with diabetes are two to three times less likely than white patients to receive the A1C test during physician office visits.
The A1C test is a “monitoring cornerstone,” providing a retrospective snapshot of a patient’s blood-glucose level, says David A. Sclar, a co-author of the commentary and the Boeing distinguished professor of health policy and administration at WSU.
“Ensuring equitable access to care is crucial if we are to reduce the morbidity, mortality and expenditures associated with diabetes,” Neumiller said.
The WSU researchers note that diabetes has become a global epidemic projected to affect 48 million Americans by 2050. Hispanics and blacks are more than twice as likely to develop diabetes and suffer the consequences of insufficient monitoring, say the WSU researchers.
Earlier this year, the American Diabetes Association announced guidelines encouraging use of the A1C test in both the monitoring and diagnosis of Type 2 diabetes, the most common form of the disease.
Comments
It would be good to know if
It would be good to know if the observed disparity in diabetes testing is a factor of ethnicity, or perhaps other factors, such as insurance coverage, education level, and income. Did the study compare black and Hispanic patients with white patients with the same levels of insurance coverage; or across the same levels of income or education. If the disparity still exists when those other factors are considered, then the strategy for addressing the disparity would be much different than if the disparity disappeared when corrected for education or insurance coverage. For example, if truly a disparity based on ethnicity, then we need to look at the bias of provider as well as cultural factors of the interation and within the patient populations themselves.
The reason I bring this up is that a number of studies going back to the 1970's show the strongest correlation between health and education. More highly educated people tend to be healthier than less educated people. This relationship holds true even when you compare educated poor people with less educated rich people.
All of this goes to show that healthy behavior is multi-dimensional. It is important to look at all confounding factors before single causation conclusions are made.
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