Cartwright Kate
University of New Mexico, USA.
SSM Popul Health. 2021 Jul 24;15:100869. doi: 10.1016/j.ssmph.2021.100869. eCollection 2021 Sep.
Latinx people living in the U.S. report a disproportionately high prevalence of diabetes. This project builds on the existing social determinants of diabetes literature by examining factors associated with a greater likelihood of diabetes and investigates factors correlated with the Latinx/non-Latinx disparity. This project studies the adult sample (18 and older) from the 2010-2018 IPUMS Health: National Health Interview Survey (NHIS) data. Logistic regression analyses are used to examine the patterns between reporting Latinx identity and reporting diabetes with additional subgroup analyses of the Latinx and non-Latinx groups. Then, Oaxaca-Blinder decomposition is used to examine the patterns explaining the difference in self-reported diabetes between the Latinx and non-Latinx population for the whole sample and by age group. The logistic regression analyses show that after adjusting for age and other key social determinants of health, Latinx individuals are approximately 64.5% (OR 1.645, [95% CI, 1.536-1.760]) more likely to report being diagnosed with diabetes than non-Latinx individuals. Individual characteristics of age, race, and smoking behaviors are identified as suppressors of the gap, and conversely, characteristics of income, education, and BMI all contribute to the Latinx diabetes disparity gap. The Oaxaca-Blinder decomposition results show that the measured social determinants of health characteristics explain a meaningful amount of the Latinx diabetes gap. Importantly, differences in education and income (which are more immediately actionable policy areas) make larger contributions to the gap than BMI or other health behaviors.
生活在美国的拉丁裔人群报告称，糖尿病患病率高得不成比例。本项目以现有的糖尿病社会决定因素文献为基础，通过研究与糖尿病可能性增加相关的因素，调查与拉丁裔/非拉丁裔差异相关的因素。本项目研究了2010 - 2018年综合公共使用微观数据系列（IPUMS）健康：国民健康访谈调查（NHIS）数据中的成人样本（18岁及以上）。使用逻辑回归分析来研究报告拉丁裔身份与报告糖尿病之间的模式，并对拉丁裔和非拉丁裔群体进行额外的亚组分析。然后，使用瓦哈卡 - 布林德分解法来研究解释整个样本以及按年龄组划分的拉丁裔和非拉丁裔人群在自我报告糖尿病方面差异的模式。逻辑回归分析表明，在调整年龄和其他关键的健康社会决定因素后，拉丁裔个体报告被诊断患有糖尿病的可能性比非拉丁裔个体高约64.5%（比值比为1.645，[95%置信区间，1.536 - 1.760]）。年龄、种族和吸烟行为等个体特征被确定为差距的抑制因素，相反，收入、教育程度和体重指数等特征都导致了拉丁裔糖尿病差异差距。瓦哈卡 - 布林德分解结果表明，所测量的健康特征社会决定因素解释了相当一部分拉丁裔糖尿病差距。重要的是，教育和收入方面的差异（这是更直接可采取行动的政策领域）对差距的贡献比体重指数或其他健康行为更大。
