Racial and ethnic disparities in healthcare use, delayed care, and management of diabetes mellitus in older adults in California

J Am Geriatr Soc. 2012 Dec;60(12):2319-25. doi: 10.1111/jgs.12003. Epub 2012 Nov 29.


This study examined racial and ethnic differences in healthcare use, delayed care, and management of care of older adults with a self-reported diagnosis of diabetes mellitus. Drawing on the 2009 California Health Interview Survey (CHIS), the sample included 3,003 adults (representative of N = 998,795) aged 60 and older from five racial and ethnic groups: non-Hispanic white (n = 2,153), African American (n = 213), Hispanic (n = 336), Asian (n = 306), and American Indian and Alaska Native (AI/AN) (n = 59). All self-reported a diagnosis of diabetes mellitus. Descriptive statistics and logistic regression analyses were conducted using weighted data. Results from adjusted logistic regressions indicated significant racial and ethnic differences between non-Hispanic white elderly and the other groups examined. Specifically, African Americans were significantly less likely than whites to see a doctor and to have a usual source of care, and were more likely to visit the emergency department (ED) for diabetes mellitus and to have their feet examined by a provider. Hispanics were significantly less likely to take medicine to lower cholesterol but were more likely to test their blood glucose regularly (following ADA guidelines). Asians were significantly less likely than whites to test their blood glucose regularly or have a foot examination. AI/ANs were significantly less likely than whites to see a doctor, visit an ED, and take medication to reduce heart attack risk but were more likely to use insulin, oral diabetic medication, or both. The findings suggest the need for racial- and ethnic-specific interventions for managing diabetes mellitus to help reduce existing racial and ethnic disparities among elderly adults.

MeSH terms

  • African Americans / statistics & numerical data
  • Aged
  • Asian Americans / statistics & numerical data
  • Blood Glucose / analysis
  • California
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / ethnology*
  • Ethnic Groups / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Health Services / statistics & numerical data*
  • Health Surveys
  • Healthcare Disparities
  • Hispanic Americans / statistics & numerical data
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Indians, North American / statistics & numerical data
  • Male
  • Patient Compliance / statistics & numerical data*


  • Blood Glucose
  • Hypoglycemic Agents