|Racial, ethnic, and urban/rural differences in transitions into diabetes: Evidence from the Health and Retirement Survey biomarker and self-reported data
|Year of Publication
|Hyeran, C, Arends-Kuenning, MPaula
|biomarker data, Diabetes, ethnicity, race, rural, self reported, urban
We examine the differences in transitions between stages of type 2 diabetes across racial, ethnic, and urban/rural statuses. The individual-level data from the 2006 to 2012 waves of the Health and Retirement Survey (HRS) and county-level data from the 1990-2000 US Censuses, the Dartmouth Atlas of Health Care, and the Inter-university Consortium for Political and Social Research are used to analyze the transition from the stage of prediabetic to diabetic, and the transition from having no diabetes to being prediabetic and diabetic. The HRS includes both biomarker data and self-reported doctors' diagnoses of diabetes, which allow us to identify people who are prediabetic and undiagnosed diabetics. Employing logistic models, we find that the likelihood of reporting the transition from prediabetes to diabetes increases with the degree of rurality. We also find that county-level proxies for structural disadvantage and individual-level correlates attenuate race/ethnicity and rurality disparities in the development of diabetes. In addition, racial/ethnic differences in transitions into diabetes are partially explained by differences in individual-level factors and further explained by differences in disadvantaged conditions associated with rural counties.