Racial Disparities in Diabetes in the US and the UK

描述(由申请人提供)：工业化国家的少数民族人口比高加索人有更高的糖尿病和并发症发生率。有证据表明，获得护理在糖尿病的检测和管理中发挥着关键作用。目前尚不清楚，与以市场为基础的医疗体系相比，全国性的普遍获得医疗体系是否缩小了糖尿病检测和控制方面的种族差异。这项为期两年的研究的目的是调查在获得护理方面的差异是否与美国和英国的种族和民族之间在糖尿病检测和控制方面的差异有关。该项目将分析来自美国国家健康和营养检查和调查(NHANES 1999-2000)和英国英国健康调查(1999)的以人口为基础的、具有全国代表性的数据。这种方法将使我们能够对每个国家的人口进行估计。这项研究有三个目的：1)比较美国和英国少数民族中糖尿病的检测和控制情况，以改善目前对糖尿病患者的护理；2)通过根据出生状况、在美国的年限、进入国家的年限和在国内讲的语言(代表多数文化的变量)对美国和英国的种族/民族在糖尿病检测和控制方面的差异进行比较；以及3)检查糖尿病的主要风险因素对美英两国种族之间糖尿病未被发现和未得到控制的可能性的影响。从目前的应用中获得的信息将增加我们对获得护理与糖尿病检测和控制中的种族差异的关系的洞察力，并将为潜在的卫生改革倡议提供新的知识。

DESCRIPTION (provided by applicant): Minority populations in industrialized countries have higher rates of diabetes and complications than their Caucasian counterparts. Evidence suggests that access to care plays a key role in detection and management of diabetes. It is unclear whether compared to a market-based system of care a nationwide system of universal access to care attenuates racial disparities in diabetes detection and control. The purpose of this two-year study is to investigate whether differences in access to care are associated with differences in detection of diabetes as well as control, between racial and ethnic groups in the United States and the United Kingdom. The project will analyze population-based, nationally representative data from the United States' National Health and Nutrition Examination and Survey (NHANES 1999-2000) and the United Kingdom's Health Survey for England (1999). This method will allow us to make population estimates for each country. The study has three aims: 1) To contrast the detection and control of diabetes among minorities in the United States with the United Kingdom with the goal of improving the current care of people with diabetes, 2) to examine differences within racial/ethnic groups on diabetes detection and control in the US and the UK by stratifying groups based on native born status, years in country, years in country/age entered country, and language spoken at home, proxy variables for acculturation to the majority culture, and 3) to examine the influence of major risk factors for diabetes on the likelihood of having undetected and uncontrolled diabetes among ethnic groups in the US and the UK. Information obtained from the current application will increase our insight into the relationship of access to care to racial disparities in diabetes detection and control and will provide new knowledge for potential health reform initiatives.