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Logo of jepicomhInstructions for authorsCurrent TOCJournal of Epidemiology and Community Health
 
J Epidemiol Community Health. Nov 2000; 54(11): 839–845.
PMCID: PMC1731578
Excess type 2 diabetes in African-American women and men aged 40-74 and socioeconomic status: evidence from the Third National Health and Nutrition Examination Survey
J. Robbins, V. Vaccarino, H. Zhang, and S. Kasl
Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104-6298, USA. Jessica_Robbins/at/pop.upenn.edu
Abstract
OBJECTIVE—To examine whether socioeconomic status (SES) explains differences in the prevalence of type 2 diabetes between African-American and non-Hispanic white women and men.
DESIGN—Cross sectional study of diabetes prevalence, SES, and other risk factors ascertained by physical examination and interview.
SETTING—Interviews were conducted in subjects' homes; physical examinations were conducted in mobile examination centres.
PARTICIPANTS—961 African-American women, 1641 non-Hispanic white women, 839 African-American men and 1537 non-Hispanic white men, aged 40 to 74 years, examined in the Third National Health and Nutrition Examination Survey (NHANES III), a representative sample of the non-institutionalised civilian population of the United States, 1988-1994.
MAIN RESULTS—Among women, African-American race/ethnicity was associated with an age adjusted odds ratio of 1.76 (95% confidence intervals 1.21, 2.57), which was reduced to 1.42 (95% confidence intervals 0.95, 2.13) when poverty income ratio was controlled. Controlling for education or occupational status had minimal effects on this association. When other risk factors were controlled, race/ethnicity was not significantly associated with type 2 diabetes prevalence. Among men, the age adjusted odds ratio associated with African-American race/ethnicity was 1.43 (95% confidence intervals 1.03, 1.99). Controlling for SES variables only modestly affected the odds ratio for African/American race/ethnicity among men, while adjusting for other risk factors increased the racial/ethnic differences.
CONCLUSIONS—Economic disadvantage may explain much of the excess prevalence of type 2 diabetes among African-American women, but not among men.


Keywords: diabetes mellitus; ethnic groups; socioeconomic factors
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