Use of Health Care Services for Cardiometabolic Risk Reduction among People with Diabetes Mellitus by Racial/Ethnic Groups in Pennsylvania

Objective: In 2005, an estimated 8% of adults aged 18 or older had type 2 diabetes mellitus (DM) in Pennsylvania (PA). The present study examines the use of health care services for cardiometabolic risk reduction among diabetics by racial/ethnic groups.

Methods: Data from 12,679 participants within the 2005 PA Behavior Risk Factor Surveillance System (BRFSS) was analyzed. Statistical analysis techniques for the complex sample designs of the BRFSS were used.

Results: Among the participant population groups, the prevalence of DM was 13.1% in African American (AA); 9.5% in Non-Hispanic White (NHW); and 6.8% in Hispanic (H). Comorbidity with hypertension was found: 74% AA, 69% H, and 65% NHW. The prevalence of diabetics with either coronary heart disease or stroke ranged from 16% to 26%. Use of cardiometabolic risk reduction services for weight loss counseling per group in those with BMI≥30 kg/m2 was 48% AA, 38% NHW, and 35% H. Use of services for diabetes management of serum A1c measurement was 91% NHW, 88% AA, and 81% H. Immunization utilization for influenza was 51% NHW, 50% AA, and 21% H, and for pneumonia vaccination: 57% NHW, 45% AA, and 38% H. Using multivariable analysis, health care plan coverage, education and race/ethnic status were significant predictors for the use of health care services.

Conclusion: Cardiometabolic prevalence, risk and outcomes do not match current utilization rates of health promotion. Efforts to improve the use of health care service should focus on diabetes education program and expanding health care plan for reducing health disparities.