Diagnosing diabetes in disadvantaged populations: the role of social participation.

OBJECTIVE

Extensive social networks improve health and reduce mortality. Our aim was to investigate the effect of social participation on the probability that people with diabetes are diagnosed by health care providers and whether these effects differ in disadvantaged populations.

METHODS

Using the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, we included 1642 adults with diabetes. Diagnosed people with diabetes reported a provider diagnosis of diabetes; undiagnosed people with diabetes had a fasting plasma glucose over 125 mg/dl. Multivariate logistic regression models were used to assess the effect of social participation on diabetes diagnosis.

RESULTS

Increased social participation led to a higher probability of being diagnosed among people with diabetes who were low-income (OR = 1.19, P < 0.10) and who did not graduate from high school (OR = 1.21, P < 0.05).

CONCLUSIONS

People with diabetes who had low incomes and who did not graduate from high school were more likely to know they had diabetes if they had more frequent social interaction. Clarifying the mechanisms through which social participation affects the diagnosis of diabetes may help in developing strategies to improve diabetes identification.