Disparities in diabetes: the nexus of race, poverty, and place

Am J Public Health. 2014 Nov;104(11):2147-55. doi: 10.2105/AJPH.2013.301420. Epub 2013 Nov 14.


Objectives: We sought to determine the role of neighborhood poverty and racial composition on race disparities in diabetes prevalence.

Methods: We used data from the 1999-2004 National Health and Nutrition Examination Survey and 2000 US Census to estimate the impact of individual race and poverty and neighborhood racial composition and poverty concentration on the odds of having diabetes.

Results: We found a race-poverty-place gradient for diabetes prevalence for Blacks and poor Whites. The odds of having diabetes were higher for Blacks than for Whites. Individual poverty increased the odds of having diabetes for both Whites and Blacks. Living in a poor neighborhood increased the odds of having diabetes for Blacks and poor Whites.

Conclusions: To address race disparities in diabetes, policymakers should address problems created by concentrated poverty (e.g., lack of access to reasonably priced fruits and vegetables, recreational facilities, and health care services; high crime rates; and greater exposures to environmental toxins). Housing and development policies in urban areas should avoid creating high-poverty neighborhoods.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Black or African American / statistics & numerical data
  • Child
  • Diabetes Mellitus / epidemiology*
  • Diabetes Mellitus / etiology
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Poverty / statistics & numerical data*
  • Prevalence
  • Racial Groups / statistics & numerical data*
  • Residence Characteristics / statistics & numerical data
  • Risk Factors
  • White People / statistics & numerical data
  • Young Adult