5028.0: Wednesday, October 24, 2001 - 8:45 AM

Abstract #28452

Maine's high mortality from diabetes: Inadequate diabetes control or incomplete analysis of surveillance data?

Nancy Sonnenfeld, PhD1, A. Marshall McBean, MD, MSc2, Paul Hebert, BA2, and Wei-Chung Yang2. (1) Department of Family Practice, University of New England College of Osteopathic Medicine, 11 Hills Beach Rd, Stella Maris Hall, Biddeford, ME 04005-9599, 207-283-0171 x2395, nsonnenfeld@mailbox.une.edu, (2) School of Public Health, Division of Health Services Research and Policy, University of Minnesota, Minneapolis

Introduction: In 1994, Maine had the sixth lowest prevalence of diabetes and the eighth highest diabetes-related mortality rate in the nation. This observation might suggest that Maine residents with diabetes are at high risk for death. Alternatively, it might result from a limitation in methods for national diabetes surveillance.

Methods: Data from the national diabetes cohort (NDC), a Medicare claims-based cohort, were compared with more conventional diabetes surveillance sources. State-specific estimates of diabetes prevalence, diabetes-related mortality, and the completeness of diabetes reporting on death certificates were examined through comparisons of data from the NDC, the National Vital Statistics System, and the Behavioral Risk Factor Surveillance System (BRFSS). The study population was limited to adults, aged 67 and older residing in 35 states.

Results: Using a combination of vital statistics and BRFSS, Maine’s death rate from diabetes in persons with diabetes was 4th highest out of 35 states. Using NDC mortality data, Maine ranked 29th. Maine death certificates did not report diabetes more frequently than the average state. Therefore, more frequent reporting of diabetes on Maine death certificates does not appear to explain this discrepancy. However, Maine’s diabetes prevalence estimated from BRFSS was statistically significantly lower than the prevalence measured from the NDC. Northern rural states with predominantly white populations tended to have lower diabetes prevalence using BRFSS compared to NDC.

Conclusions: The discrepancies between the data sources suggest that more comprehensive analysis and evaluation of national chronic disease surveillance systems are needed.

Learning Objectives: People who attend this session will be able to: 1. define surveillance and why it is important 2. identify two common data sources for surveillance for diabetes and other chronic diseases in the U.S. 3. interpret the discrepancies between Maine's diabetes-related mortality rate measured using two different methods

Keywords: Data/Surveillance, Diabetes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA