Limited health care access impairs glycemic control in low socioeconomic status urban African Americans with type 2 diabetes

Mary K. Rhee, Curtiss B. Cook, Virginia G. Dunbar, Rita M. Panayioto, Kathy J. Berkowitz, Barbara Boyd, Christopher D. George, Robert H. Lyles, Imad M. El-Kebbi, Lawrence S. Phillips

Research output: Contribution to journalArticle

36 Scopus citations

Abstract

Limited access to health care is associated with adverse outcomes, but few studies have examined its effect on glycemic control in minority populations. Our observational cross-sectional study examined whether differences in health care access affected hemoglobin A1c (HbA1c) levels in 605 patients with diabetes (56% women; 89% African American; average age, 50 years; 95% with type 2 diabetes) initially treated at a municipal diabetes clinic. Patients who had difficulty obtaining care had higher A1c levels (9.4% vs. 8.7%; p=0.001), as did patients who used acute care facilities (9.5%; p<0.001) or who had no usual source of care (10.3%; p<0.001) compared with those who sought care at doctors' offices or clinics (8.6%). In adjusted analyses, HbA1c was higher in persons who gave a history of trouble obtaining medical care (0.57%; p=0.04), among persons who primarily used an acute care facility to receive their health care (0.49%; p=0.047), and in patients who reported not having a usual source of care (1.08%; p=0.009). Policy decisions for improving diabetes outcomes should target barriers to health care access and focus on developing programs to help high-risk populations maintain a regular place of health care.

Original languageEnglish (US)
Pages (from-to)734-746
Number of pages13
JournalJournal of Health Care for the Poor and Underserved
Volume16
Issue number4
StatePublished - Nov 1 2005

Keywords

  • African Americans
  • Diabetes mellitus, type 2
  • Glycemic control
  • Health services accessibility
  • Socioeconomic factors

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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    Rhee, M. K., Cook, C. B., Dunbar, V. G., Panayioto, R. M., Berkowitz, K. J., Boyd, B., George, C. D., Lyles, R. H., El-Kebbi, I. M., & Phillips, L. S. (2005). Limited health care access impairs glycemic control in low socioeconomic status urban African Americans with type 2 diabetes. Journal of Health Care for the Poor and Underserved, 16(4), 734-746.