Race, socioeconomic status, and rurality influences on type 2 diabetes management among North Carolina adults.

PURPOSE: To examine the impact of race, socioeconomic status, and rurality on Type 2 diabetes education among adults in North Carolina. METHODS: Our study utilized data from the 2008 Behavioral Risk Factor Surveillance System (BRFSS) to conduct a retrospective study and secondary data analysis. To account for the multistage survey design of BRFSS, SAS/SUDAAN was used to calculate adjusted and unadjusted odds ratios and 95% confidence intervals (CIs). Univariate, bivariate, and multivariate analyses were performed to examine the association between race, socioeconomic status, and rurality and its effects on type 2 diabetes education among adults in North Carolina. MAIN FINDINGS: The majority of the participants (63%) did not have good diabetes education. Non-Whites had higher odds than Whites of good diabetes education (OR=1.56, 95%CI: 1.19, 2.03). Individuals who lived in rural North Carolina had lower odds of having good diabetes education than their urban counterparts, but the results remained insignificant (OR=.88, CI: .67, 1.15). Individuals who were of low socioeconomic status (SES) had poorer diabetes education than individuals who were identified as being high SES, but the results were insignificant (OR=.81, CI: .60, 1.09). PRINCIPAL CONCLUSIONS: Findings from the study indicate that non-White adults had higher odds than Whites of good type 2 diabetes education in North Carolina. The results of our study could be used for policies and recommendations for health organizations. Policy makers should make diabetes education mandatory for individuals who are diagnosed with this disease. Future studies should have a more accurate measurement of type 2 diabetes education.

Race, socioeconomic status, health-related quality of life, and self-care of type 2 diabetes mellitus among adults in North Carolina.

OBJECTIVES: The objective of this study was to examine the associations among race, education, income, and health-related quality of life (HRQoL) in self-care of type 2 diabetes mellitus among adults in North Carolina. METHODS: A secondary analysis was conducted using data from the 2009 Behavioral Risk Factor Surveillance Survey (BRFSS), a large population-based survey (N = 432,607) conducted in the United States. The data were analyzed to account for the weighted complex multistage sampling design of the Behavioral Risk Factor Surveillance Survey. Parametric testing using univariate/bivariate/multivariate analysis was performed. RESULTS: The majority of participants reported taking a class/course on diabetes mellitus management and having checked their blood glucose levels at least once per day. The majority (61.26%) of the participants did not have good self-management skills, based on the education and blood glucose-monitoring criteria established for this study. Participants with poor HRQoL had significantly increased odds of good diabetes mellitus self-care practices. CONCLUSIONS: Individuals with poor HRQoL had significantly increased odds of good diabetes mellitus self-care practices. Although findings on race, education, and income were not statistically significant, they were consistent with previous research. In the future, individuals who are nonwhite, have less than a high school level of education, and have no health insurance should be targeted to improve diabetes mellitus self-care practices through educational and informational materials. Further investigation using more comprehensive measures of diabetes mellitus self-care is warranted.