Diabetes Burden and Access to Preventive Care in the Rural United States

Krishna, Santosh; Gillespie, Kathleen N.; McBride, Timothy D.

doi:10.1111/j.1748-0361.2009.00259.x

Cited by 112 publications

(85 citation statements)

References 21 publications

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“…This could reflect a very high prevalence of prediabetes among Black adolescents in North Texas, but could also be in part attributable to previously reported glucose-independent racial differences in HbA1C levels. 19 The lower observed prevalence of abnormal HbA1C in rural versus urban donor-sites is somewhat surprising given the higher prevalence of diabetes in rural adults, 20 the higher prevalence of obesity in rural children, 21 as well as the overall 'rural health disadvantage' described in the United States. 22 However, since the present cohort is not a probability-based population sample, we are unable to infer that prediabetes is less prevalent in rural versus urban North Texas adolescents in general.…”

Section: Sex Race/ethnicity and Rural Versus Urban Settingmentioning

confidence: 99%

High prevalence of elevated haemoglobin A1C among adolescent blood donors: Results from a voluntary screening programme including 31,546 adolescents

Gore

Eason

Ayers

et al. 2015

Diabetes and Vascular Disease Research

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More than 1 in 10 US adolescents have prediabetes or diabetes, and elevated glycosylated haemoglobin (HbA1C) in youth is associated with increased risk of death before the age of 55 years. We conducted a prospective, cross-sectional study of 31,546 consecutive volunteer blood donors, 16-19 years of age, who donated blood during school blood drives between 1 September 2011 and 21 December 2012 in Texas. In the overall cohort, the prevalence of elevated HbA1C was 11.5%, including 11.0% in the prediabetes range (HbA1C 5.7%-6.4%) and 0.5% in the diabetes range (HbA1C ⩾ 6.5%). The prevalence of elevated HbA1C was higher in boys compared with girls (15.7% vs 7.9%, p < 0.001) and was especially high in racial/ethnic minorities (Blacks 32.7%, Asians 19.7%, Hispanics 13.1%) compared with Whites (8.0%, p < 0.001). There was a significant increase in total cholesterol and blood pressure across categories of increasing HbA1C in the overall cohort and stratified by sex and race/ethnicity. Blood donation programmes can serve as unique portals for health screening with potential for intervention in adolescents.

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Section: Sex Race/ethnicity and Rural Versus Urban Settingmentioning

confidence: 99%

High prevalence of elevated haemoglobin A1C among adolescent blood donors: Results from a voluntary screening programme including 31,546 adolescents

Gore

Eason

Ayers

et al. 2015

Diabetes and Vascular Disease Research

View full text Add to dashboard Cite

show abstract

“…In addition to being a medically underserved population, U.S. rural residents experience more disease and greater health and health care disparities than urban residents [12,13] . Specifically, compared to the urban population, rural populations have higher prevalences of uninsured adults, adults with chronic conditions such as diabetes and cardiovascular disease, adolescent and adult smoking, and below-guideline consumption of fruits and vegetables [12][13][14][15][16][17][18][19] . Other important disparities in social determinants of health have also been detected for rural U.S. residents including higher poverty levels and lower levels of attained education.…”

Section: Introductionmentioning

confidence: 99%

Rural/Urban differences in health services deficits among U.S. adults with arthritis: A population- based study

Lutfiyya

McCullough

Saman

et al. 2013

JNEP

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Introduction: More than 21% of adults in the United States (U.S.) have self-reported physician diagnosed arthritis with the prevalence increasing to 70% for adults aged 75 years and older. Despite significant disease burden of arthritis, little research has been conducted to examine health service deficits experienced by U.S. adults with this disease. Since U.S. rural residents experience more disease and greater health and health care disparities than urban residents, this study sought to ascertain the prevalence of health service deficits in U.S. adults with arthritis and to explore whether rural residents experienced greater deficits than urban residents. Methods:Multivariate techniques were performed on 2011 Behavioral Risk Factor Surveillance System data to determine if there were differences in the prevalence of health service deficits in rural versus urban adults with arthritis and if rural residency was an independent risk factor for health service deficits after controlling for socioeconomic status and race/ ethnicity. The population of interest was U.S. adults who self-reported having arthritis diagnosed by a health care provider.Results: Bivariate analysis revealed and logistic regression confirmed that among U.S. adults > 45 years of age, rural residency was a predictor for a higher prevalence of arthritis as well as for health service deficits among those with arthritis. Overall about 1 in 3 individuals > 45 years of age suffering from arthritis experienced a health deficit. The two most common health service deficits were not having a routine medical checkup within the last 12 months and deferring health care because of cost. Rural residency emerged as an independent risk factor for health service deficits after controlling for socioeconomic status and race/ethnicity. Conclusions:Many individuals with arthritis experience a health service deficit and rural residents are at greater risk when compared to their urban counterparts. Given the burden of disease from arthritis the results suggest that there is considerable potential for improving services and perhaps improving outcomes for individuals with arthritis. The finding that the most common health service deficits were delaying care because of cost and not having seen a provider within the last 12 months suggests that finances rather than simply the availability of services is a key factor.

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“…Eliminating health disparities among rural communities is a Healthy People 2020 1 objective, because rural adults and youth in the United States currently face disproportionately higher risk for nutrition-related chronic diseases when compared to urban residents (Krishna, Gillespie, & McBride, 2010). Indeed, the obesity prevalence rate was 39.6 percent of rural adults compared to 33.4 percent of urban adults, and remained significantly higher even after controlling for demographic, diet, and physical activity (Befort, Nazir, & Perri, 2012).…”

Section: Introductionmentioning

confidence: 99%

Advancing Rural Food Access Policy Research Priorities: Process and Potential of a Transdisciplinary Working Group

Fleischhacker

Johnson

Quinn

et al. 2013

JAFSCD

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Diabetes Burden and Access to Preventive Care in the Rural United States

Abstract: Rural residents in both datasets had higher prevalence of diabetes. Though not always statistically significant, the trend was to less guideline compliance in rural areas.

Cited by 112 publications

References 21 publications

High prevalence of elevated haemoglobin A1C among adolescent blood donors: Results from a voluntary screening programme including 31,546 adolescents

High prevalence of elevated haemoglobin A1C among adolescent blood donors: Results from a voluntary screening programme including 31,546 adolescents

Rural/Urban differences in health services deficits among U.S. adults with arthritis: A population- based study

Advancing Rural Food Access Policy Research Priorities: Process and Potential of a Transdisciplinary Working Group

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