Racial Disparities in Diabetes in the US and the UK

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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.