Abstract P165: Trends in Diabetes by Socioeconomic Status between 1999-2010: National Health and Nutrition Examination Surveys
Background: Diabetes (DM) is more common among adults with lower socioeconomic status (SES). However, it is not known whether the socioeconomic disparities in DM are obscured by the overall rising prevalence of DM. Our objective was to test whether disparities in diabetes by SES have changed between 1999 and 2010.
Methods: Participants from National Health and Nutrition Examination Surveys aged > 20 years with data available to determine DM at each examination were included (n= 11,952). DM was determined as fasting glucose ≥126 mg/dL or self-report of DM medication use. Educational attainment was used to represent SES and categorized into 4 groups. Predictive marginal probabilities from logistic regression models were used to calculate the age-standardized prevalence of DM by educational category across 3 survey periods (1999-2002, 2003-2006, 2007-2010). We tested whether the relationship of SES with DM changed over time using interaction terms between education and survey period.
Results: The age-standardized prevalence of diabetes was 8.5% (95% CI: 7.3-9.7) in 1999-2002, 9.6% (95% CI: 8.4-10.7) in 2003-2006 and 11.3% (95% CI: 10.0-12.5) in 2007-2010. In each survey period, DM prevalence was highest among adults with the least education (p<0.01) and that relationship did not change over time (p=0.50 for education*year). When we stratified by race/ethnicity, non-Hispanic whites and blacks had the same socioeconomic patterning over time as the total population (Figure). However, education was not associated with DM in Mexican Americans, and this did not change over time.
Conclusion: Socioeconomic disparities in DM persist over time; however, the inverse gradient in DM prevalence is not present in Mexican Americans.
Author Disclosures: M.R. Carnethon: None. P.D. De Chavez: None. L.J. Rasmussen-Torvik: None. V. Womack: None. K. Kershaw: None.
- © 2014 by American Heart Association, Inc.