Huyser Kimberly R, Rockell Jennifer, Jernigan Valarie Blue Bird, Taniguchi Tori, Wilson Charlton, Manson Spero M, O'Connell Joan
Department of Sociology, University of New Mexico, Albuquerque, NM, USA.
Telligen, Greenwood Village, CO, USA.
Curr Dev Nutr. 2019 Aug 6;4(Suppl 1):42-48. doi: 10.1093/cdn/nzz089. eCollection 2020 Jan.
The American Indian (AI) population experiences significant diet-related health disparities including diabetes and cardiovascular disease (CVD). Owing to the relatively small sample size of AIs, the population is rarely included in large national surveys such as the NHANES. This exclusion hinders efforts to characterize potentially important differences between AI men and women, track the costs of these disparities, and effectively treat and prevent these conditions.
We examined the sex differences in diabetes prevalence, comorbidity experience, health care utilization, and treatment costs among AIs within a Northern Plains Indian Health Service (IHS) service unit.
We assessed data from a sample of 11,144 persons using an IHS service unit in the Northern Plains region of the United States. Detailed analyses were conducted for adults ( = 7299) on prevalence of diabetes by age and sex. We described sex differences in comorbidities, health care utilization, and treatment costs among the adults with diabetes.
In our sample, adult men and women had a similar prevalence of diabetes (10.0% and 11.0%, respectively). The prevalence of CVD among men and women with diabetes was 45.7% and 34.0%, respectively. Among adults with diabetes, men had a statistically higher prevalence of hypertension and substance use disorders than women. The men were statistically less likely to have a non-substance use mental health disorder. Although men had higher utilization and costs for hospital inpatient services than women, the differences were not statistically significant.
In this AI population, there were differences in comorbidity profiles between adult men and women with diabetes, which have differential mortality and cost consequences. Appropriate diabetes management addressing gender-specific comorbidities, such as substance use disorders for men and non-substance use mental health disorders for women, may help reduce additional comorbidities or complications to diabetes.
美国印第安人（AI）群体面临与饮食相关的重大健康差异，包括糖尿病和心血管疾病（CVD）。由于AI群体样本量相对较小，该群体很少被纳入诸如美国国家健康与营养检查调查（NHANES）等大型全国性调查。这种排除阻碍了对AI男性和女性之间潜在重要差异进行特征描述、追踪这些差异的成本以及有效治疗和预防这些疾病的努力。
我们研究了美国北部平原印第安卫生服务（IHS）服务单位内AI群体中糖尿病患病率、合并症情况、医疗保健利用情况和治疗成本的性别差异。
我们评估了来自美国北部平原地区一个IHS服务单位的11144人的样本数据。对成年人（n = 7299）按年龄和性别进行了糖尿病患病率的详细分析。我们描述了糖尿病成年患者中合并症、医疗保健利用情况和治疗成本的性别差异。
在我们的样本中，成年男性和女性的糖尿病患病率相似（分别为10.0%和11.0%）。糖尿病男性和女性的心血管疾病患病率分别为45.7%和34.0%。在糖尿病成年患者中，男性高血压和物质使用障碍的患病率在统计学上高于女性。男性患非物质使用心理健康障碍的可能性在统计学上较低。尽管男性住院患者服务的利用率和成本高于女性，但差异无统计学意义。
在这个AI群体中，糖尿病成年男性和女性的合并症情况存在差异，这会导致不同的死亡率和成本后果。针对特定性别的合并症进行适当的糖尿病管理，如男性的物质使用障碍和女性的非物质使用心理健康障碍，可能有助于减少糖尿病的额外合并症或并发症。
