The Relationship Between County-Level Contextual Characteristics and Use of Diabetes Care Services
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The Relationship Between County-Level Contextual Characteristics and Use of Diabetes Care Services

Filetype[PDF-124.13 KB]


  • English
    • Details Supporting Files You May Also Like

    Details:

    • Alternative Title:
      J Public Health Manag Pract
    • Publisher's site:
      http://dx.doi.org/10.1097/PHH.0b013e31829bfa60
    • Personal Author:
    • Description:
      Objectives

      To examine the relationship between county-level measures of social determinants and use of preventive care among US adults with diagnosed diabetes. To inform future diabetes prevention strategies.

      Methods

      Data are from the Behavioral Risk Factor Surveillance System (BRFSS) 2004 and 2005 surveys, the National Diabetes Surveillance System, and the Area Resource File. Use of diabetes care services was defined by self-reported receipt of 7 preventive care services. Our study sample included 46 806 respondents with self-reported diagnosed diabetes. Multilevel models were run to assess the association between county-level characteristics and receipt of each of the 7 preventive diabetes care service after controlling for characteristics of individuals. Results were considered significant if P < .05.

      Results

      Controlling for individual-level characteristics, our analyses showed that 7 of the 8 county-level factors examined were significantly associated with use of 1 or more preventive diabetes care services. For example, people with diabetes living in a county with a high uninsurance rate were less likely to have an influenza vaccination, visit a doctor for diabetes care, have an A1c test, or a foot examination; people with diabetes living in a county with a high physician density were more likely to have an A1c test, foot examination, or an eye examination; and people with diabetes living in a county with more people with less than high-school education were less likely to have influenza vaccination, pneumococcal vaccination, or self-care education (all P < .05).

      Conclusions

      Many of the county-level factors examined in this study were found to be significantly associated with use of preventive diabetes care services. County policy makers may need to consider local circumstances to address the disparities in use of these services.

    • Subject:
    • Source:
      J Public Health Manag Pract. 20(4):401-410.
    • Pubmed ID:
      23963254
    • Pubmed Central ID:
      PMC4834855
    • Document Type:
      Journal Article
    • Funding:
      CC999999/Intramural CDC HHS/United States
    • Name as Subject:
      Behavioral Risk Factor Surveillance System (U.S.)
    • Collection(s):
      CDC Public Access
    • Main Document Checksum:
    • File Type:

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