Health insurance and diabetes among multiracial men: The mediation effects of usual source of care

Background: Frequently, the men located in lower SES categories are men of color, often omitted from research studies, and increasingly found to suffer from worse health conditions that are currently recognized as health disparities (Gaskin et al., 2007; Jack, Toston, Jack, & Sims, 2008; Porche, 2007). Health insurance and having a usual source of care is important in diabetes management for multi-ethnic men. Few studies focus on determining whether usual source of care mediates the association between health insurance and diabetes among men. Methods: Using data from the 2005 California Health Interview Survey, we analyzed responses from 17,472 men to examine the extent to which a usual source of health care mediates the relationship between health insurance and diabetes. Logistic regression analyses were performed and a Sobel-Goodman test for mediation was calculated for each racial group to determine the relative impact of usual source of care on the main study relationship. Results: Sobel-Goodman tests for mediation indicated the largest effects between Latino and White men. For African American and Asian men, usual source of care did not serve as a significant mediation factor between health insurance and diabetes. Discussion: Findings highlight that preventing the decline of men's health in general, and specifically among African American, Latino, and Asian American men should be an important priority. Social service workers need to advocate for better screening and treatment for diseases such as diabetes for multi-racial men in a variety of health settings.