Racial and Ethnic Disparities in Diabetes Screening Between Asian Americans and Other Adults: BRFSS 2012-2014

J Gen Intern Med. 2017 Apr;32(4):423-429. doi: 10.1007/s11606-016-3913-x. Epub 2016 Nov 15.

Abstract

Background: Although Asian Americans are at high risk for type 2 diabetes, it is not known whether they are appropriately screened for this disease.

Objective: To assess racial and ethnic disparities in diabetes screening between Asian Americans and other adults.

Design: Analysis of pooled cross-sectional data from 45 U.S. states and territories using the 2012-2014 Behavioral Risk Factor Surveillance System. We calculated the weighted proportions of adults in each racial and ethnic group who received recommended diabetes screening. To assess for racial and ethnic disparities, we used multivariable logistic regression to model receipt of recommended diabetes screening as a function of race and ethnicity, adjusting for demographics, healthcare access, survey year, and state.

Participants: A total of 526,000 adults who were eligible to receive diabetes screening according to American Diabetes Association guidelines from 2012 to 2014 (age ≥ 45 years or age < 45 years with a body mass index [BMI] ≥ 25 kg/m2).

Main measures: Self-reported receipt of diabetes screening (defined as a test for high blood sugar or diabetes within the past 3 years) and self-reported race/ethnicity (non-Hispanic white, non-Hispanic Asian, non-Hispanic Pacific Islander, non-Hispanic American Indian or Alaskan Native, non-Hispanic black, Hispanic or Latino, and non-Hispanic multiracial or other).

Key results: Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening. Overall, Asian Americans had 34% lower adjusted odds of receiving recommended diabetes screening compared to non-Hispanic whites (95 % CI: 0.60, 0.73). In subgroup analyses by age and weight status, disparities were widest among obese Asian Americans ≥ 45 years (AOR = 0.56; 95 % CI: 0.39, 0.81). Disparities persisted among Asian Americans who completed other types of preventive cancer screening.

Conclusions: Despite their high risk of diabetes, Asian Americans were the least likely racial and ethnic group to receive recommended diabetes screening.

Keywords: Asian Americans; diabetes screening; primary care; racial and ethnic disparities.

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data
  • Aged
  • Asian Americans / statistics & numerical data*
  • Behavioral Risk Factor Surveillance System
  • Cross-Sectional Studies
  • Diabetes Mellitus, Type 2 / diagnosis*
  • Diabetes Mellitus, Type 2 / ethnology*
  • Female
  • Health Services Accessibility / statistics & numerical data
  • Healthcare Disparities / ethnology*
  • Healthcare Disparities / statistics & numerical data
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Socioeconomic Factors
  • United States / epidemiology
  • Whites / statistics & numerical data
  • Young Adult