Smith James P
Rand Corporation, 1776 Main Street, Santa Monica, CA 90407, USA.
Proc Natl Acad Sci U S A. 2007 Aug 14;104(33):13225-31. doi: 10.1073/pnas.0611234104.
This paper investigates levels in diabetes prevalence patterns across key socioeconomic status indicators and how they changed over time. The investigation spans both the conventional concept of diagnosed diabetes and a more comprehensive measure that includes those whose diabetes is undiagnosed. By doing so, I separate the distinct impact of covariates on trends over time in disease onset and the probability of disease diagnosis. The principal force leading to higher diabetes prevalence over time is excessive weight and obesity, which was only partially offset by improvements in the education of the population over time. Undiagnosed diabetes remains an important health problem, but much less so than 25 years ago. Although race and ethnic differentials in undiagnosed diabetes were eliminated over the last 25 years, the disparities became larger across other measures of disadvantage, such as education.
本文研究了关键社会经济地位指标下糖尿病患病率模式的水平，以及这些水平随时间的变化情况。该调查涵盖了已诊断糖尿病的传统概念以及一个更全面的衡量标准，其中包括那些糖尿病未被诊断出的人群。通过这样做，我区分了协变量对疾病发病趋势和疾病诊断概率随时间的不同影响。导致糖尿病患病率随时间上升的主要因素是超重和肥胖，而随着时间推移人口教育水平的提高只是部分抵消了这一因素。未被诊断出的糖尿病仍然是一个重要的健康问题，但比25年前要轻得多。尽管在过去25年里未被诊断出的糖尿病在种族和族裔方面的差异已消除，但在其他劣势衡量标准（如教育程度）方面的差距却变得更大。
