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Differential effect of race, education, gender, and language discrimination on glycemic control in adults with type 2 diabetes. Diabetes Technol Ther 2015 Apr;17(4):243-7

Date

12/31/2014

Pubmed ID

25549154

Pubmed Central ID

PMC4365429

DOI

10.1089/dia.2014.0285

Scopus ID

2-s2.0-84925086728   17 Citations

Abstract

BACKGROUND: Discrimination has been linked to negative health outcomes, but little research has investigated different types of discrimination to determine if some have a greater impact on outcomes. We examined the differential effect of discrimination based on race, level of education, gender, and language on glycemic control in adults with type 2 diabetes.

PATIENTS AND METHODS: Six hundred two patients with type 2 diabetes from two adult primary care clinics in the southeastern United States completed validated questionnaires. Questions included perceived discrimination because of race/ethnicity, level of education, sex/gender, or language. A multiple linear regression model assessed the differential effect of each type of perceived discrimination on glycemic control while adjusting for relevant covariates, including race, site, gender, marital status, duration of diabetes, number of years in school, number of hours worked per week, income, and health status.

RESULTS: The mean age was 61.5 years, and the mean duration of diabetes was 12.3 years. Of the sample, 61.6% were men, and 64.9% were non-Hispanic black. In adjusted models, education discrimination remained significantly associated with glycemic control (β=0.47; 95% confidence interval, 0.03, 0.92). Race, gender and language discrimination were not significantly associated with poor glycemic control in either unadjusted or adjusted analyses.

CONCLUSIONS: Discrimination based on education was found to be significantly associated with poor glycemic control. The findings suggest that education discrimination may be an important social determinant to consider when providing care to patients with type 2 diabetes and should be assessed separate from other types of discrimination, such as that based on race.

Author List

Reynolds DB, Walker RJ, Campbell JA, Egede LE

Authors

Jennifer Annette Campbell PhD, MPH Assistant Professor in the Medicine department at Medical College of Wisconsin
Leonard E. Egede MD Center Director, Chief, Professor in the Medicine department at Medical College of Wisconsin
Rebekah Walker PhD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

African Americans
Aged
Blood Glucose
Diabetes Mellitus, Type 2
Educational Status
Employment
Female
Health Status
Humans
Language
Male
Marital Status
Middle Aged
Racism
Sex Factors
Sexism
Social Discrimination
Socioeconomic Factors
Southeastern United States