Medical risk factors, healthcare access and perceived health among Latinas with a history of gestational diabetes mellitus

Objective: To identify patterns and predictors of healthcare access and use among Latinas of childbearing age at risk for type 2 diabetes, due to their history of gestational diabetes mellitus (hGDM).

Research Design and Methods: We performed a cross-sectional study using 2001-2003 Behavioral Risk Factor Surveillance System data. We assessed access to healthcare, cholesterol measurement and elevation, blood pressure elevation, and perceptions of health and impairment among Latinas compared to non-Hispanic white (NHW) women aged 18-44 years with hGDM [n=3,901]. Multivariate models adjusted for sociodemographic characteristics, health insurance, current smoking, body mass index (bmi), and presence of children in the household.

Results: Among Latinas, 38% lacked health insurance and 37% reported no healthcare provider, compared to 15% of NHWs. The mean bmi's were significantly higher for Latinas. Almost a quarter of Latinas and 9% of NHWs reported fair to poor health. In multivariate analyses, Latinas were 1.7 times more likely than NHWs to lack health insurance (p<.01), 2.2 times more likely to report no primary healthcare provider (p<.001), 1.8 times as likely to be overweight (p < .01), 1.6 times as likely to be obese (p < .05), and 1.8 times more likely to report fair to poor health (p<.01).

Conclusions: The incidence of type 2 diabetes is very high among Latinas with hGDM with serious consequences for themselves, their infants, families and communities. Policies and programs that reduce barriers to health insurance and healthcare are essential to identifying and reducing risk factors for type 2 diabetes and its complications.