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群糖尿病和并发症的发病率高于高加索人。有证据表明，获得护理在糖尿病的检测和管理中起着关键作用。目前尚不清楚，与基于市场的护理系统相比，全国范围的普遍获得护理系统是否会削弱糖尿病检测和控制方面的种族差异。这项为期两年的研究旨在调查美国和英国种族和民族之间获得护理的差异是否与糖尿病检测和控制的差异有关。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）和英国英格兰健康调查（1999）的以人口为基础的全国代表性数据。这种方法将使我们能够对每个国家的人口进行估计。这项研究有三个目标：1）对比美国和英国少数民族糖尿病的检测和控制，目的是改善糖尿病患者的当前护理，2）通过基于本地出生状态、在该国的年数、在该国的年数/进入该国的年龄和在家中使用的语言对组进行分层，检查美国和英国种族/民族群体在糖尿病检测和控制方面的差异，代理变量的文化适应的主流文化，和3）检查糖尿病的主要危险因素的影响，在美国和英国的种族群体中有未被发现和未控制的糖尿病的可能性。从当前应用程序中获得的信息将增加我们对糖尿病检测和控制中获得护理与种族差异之间关系的洞察力，并将为潜在的卫生改革举措提供新的知识。

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.