Socioeconomic status and race/ethnicity independently predict health decline among older diabetics.

TitleSocioeconomic status and race/ethnicity independently predict health decline among older diabetics.
Publication TypeJournal Article
Year of Publication2011
AuthorsNicklett, EJ
JournalBMC Public Health
Date Published2011 Sep 02
ISSN Number1471-2458
KeywordsAged, Aged, 80 and over, Black People, Diabetes Mellitus, Type 2, Diagnostic Self Evaluation, Female, Follow-Up Studies, Health Status Disparities, Hispanic or Latino, Humans, Male, Social Class, United States, White People

BACKGROUND: There are pervasive racial and socioeconomic differences in health status among older adults with type 2 diabetes. The extent to which racial/ethnic and socioeconomic disparities unfold to differential health outcomes has yet to be investigated among older adults with diabetes. This study examines whether or not race/ethnicity and SES are independent predictors of steeper rates of decline in self-rated health among older adults in the U.S. with type 2 diabetes.

METHODS: The study population was a subset of diabetic adults aged 65 and older from the Health and Retirement Study. Respondents were followed up to 16 years. Multilevel cumulative logit regression models were used to examine the contributions of socioeconomic indicators, race/ethnicity, and covariates over time. Health decline was measured as a change in self-reported health status over the follow-up period.

RESULTS: Relative to whites, blacks had a significantly lower cumulative odds of better health status over time (OR: 0.61, p < .0001). Hispanics reported significantly lower cumulative odds better health over time relative to whites (OR: 0.59, p < .05). Although these disparities narrowed when socioeconomic characteristics were added to the model, significant differences remained. Including socioeconomic status did not remove the health effects of race/ethnicity among blacks and Hispanics.

CONCLUSIONS: The author found that race/ethnicity and some socioeconomic indicators were independent predictors of health decline among older adults with diabetes.


Nicklett, Emily J Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, P.H.S. England BMC public health BMC Public Health. 2011 Sep 2;11:684.

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Endnote Keywords

African Continental Ancestry Group/ statistics/African Continental Ancestry Group/ statistics/numerical data/Aged, 80 and over/Diabetes Mellitus, Type 2/ ethnology/Diabetes Mellitus, Type 2/ ethnology/Diagnostic Self Evaluation/Diagnostic Self Evaluation/European Continental Ancestry Group/ statistics/European Continental Ancestry Group/ statistics/numerical data/Female/Follow-Up Studies/Follow-Up Studies/Health Status Disparities/Hispanic Americans/ statistics/Hispanic Americans/ statistics/numerical data/Humans/Social Class/United States

Endnote ID


Alternate JournalBMC Public Health
Citation Key7635
PubMed ID21888645
PubMed Central IDPMC3175469