Health Care Disparities in Diabetes and Diabetic Retinopathy

Paul J. Bryar; Andrew Wang; Sarah E. Eichinger; Samantha Agron; Anne Langguth; Michael Mbagwu; Dustin D. French

doi:10.1080/09286586.2023.2168015

Health Care Disparities in Diabetes and Diabetic Retinopathy

Paul J. Bryar^*, Andrew Wang, Sarah E. Eichinger, Samantha Agron, Anne Langguth, Michael Mbagwu, Dustin D. French

^*Corresponding author for this work

Ophthalmology

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Purpose: To investigate prevalence of diabetes (DM), diabetic retinopathy (DR), and areas with highest rates of undetected DR. To quantify and map locations of disparities as they relate to poverty and minority populations. Methods: Retrospective cohort study from large regional health data repository (HealthLNK). Geographic Information System (GIS) analysis mapped rates of DM and DR in Chicago area ZIP Codes. Results: Of 1,086,921 adults who met the inclusion criteria, 143,790 with DM were identified. ZIP Codes with higher poverty rates were correlated with higher prevalence of DM and DR (Pearson’s correlation coefficient 0.614, p < .05, 0.333, p < .05). Poverty was negatively correlated with likelihood of DR diagnosis (−0.638, p < .05). Relative risks of DM and DR were calculated in each ZIP Code and compared to actual rates. 36 high-risk ZIP Codes had both high-risk of DM and low DR detection. In high-risk ZIP Codes 85.4% of households self-identified as ethnic minority and 33.0% were below the Federal Poverty Level (FPL). Both percentages were significantly higher than the Chicago average of 50.5% minority and 19.9% below FPL (p < .05). 67 ideal ZIP Codes had both low risk of DM and high DR detection. In ideal ZIP Codes 32.6% of households self-identified as minority, and 10.2% were below the FPL (p < .05). Conclusions: A health care disparity exists with regards to DM and DR. High-risk ZIP Codes are associated with higher poverty and higher minority population, and they are highly concentrated in just 17% of the ZIP codes in the Chicago area.

Original language	English (US)
Pages (from-to)	453-461
Number of pages	9
Journal	Ophthalmic Epidemiology
Volume	30
Issue number	5
DOIs	https://doi.org/10.1080/09286586.2023.2168015
State	Published - 2023

Funding

This work was supported by the National Institutes of Health [1R21EY024050-01A]. “Understanding Diabetic Eye Disease in the Underserved Using Health Data Exchange”.Supported by an unrestricted grant from Research to Prevent Blindiness, New York, NY. The authors would like to acknowledge Jess Behrens MS, Kathryn Jackson MS, and Theresa Walunas PhD for their assistance with data acquisition and analysis.

Keywords

Health care disparity
diabetes
diabetic eye disease

ASJC Scopus subject areas

Ophthalmology
Epidemiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1080/09286586.2023.2168015

Cite this

@article{ce564c07cfef41cfa308969af72a85fa,

title = "Health Care Disparities in Diabetes and Diabetic Retinopathy",

abstract = "Purpose: To investigate prevalence of diabetes (DM), diabetic retinopathy (DR), and areas with highest rates of undetected DR. To quantify and map locations of disparities as they relate to poverty and minority populations. Methods: Retrospective cohort study from large regional health data repository (HealthLNK). Geographic Information System (GIS) analysis mapped rates of DM and DR in Chicago area ZIP Codes. Results: Of 1,086,921 adults who met the inclusion criteria, 143,790 with DM were identified. ZIP Codes with higher poverty rates were correlated with higher prevalence of DM and DR (Pearson{\textquoteright}s correlation coefficient 0.614, p < .05, 0.333, p < .05). Poverty was negatively correlated with likelihood of DR diagnosis (−0.638, p < .05). Relative risks of DM and DR were calculated in each ZIP Code and compared to actual rates. 36 high-risk ZIP Codes had both high-risk of DM and low DR detection. In high-risk ZIP Codes 85.4% of households self-identified as ethnic minority and 33.0% were below the Federal Poverty Level (FPL). Both percentages were significantly higher than the Chicago average of 50.5% minority and 19.9% below FPL (p < .05). 67 ideal ZIP Codes had both low risk of DM and high DR detection. In ideal ZIP Codes 32.6% of households self-identified as minority, and 10.2% were below the FPL (p < .05). Conclusions: A health care disparity exists with regards to DM and DR. High-risk ZIP Codes are associated with higher poverty and higher minority population, and they are highly concentrated in just 17% of the ZIP codes in the Chicago area.",

keywords = "Health care disparity, diabetes, diabetic eye disease",

author = "Bryar, {Paul J.} and Andrew Wang and Eichinger, {Sarah E.} and Samantha Agron and Anne Langguth and Michael Mbagwu and French, {Dustin D.}",

note = "Funding Information: This work was supported by the National Institutes of Health [1R21EY024050-01A]. “Understanding Diabetic Eye Disease in the Underserved Using Health Data Exchange”.Supported by an unrestricted grant from Research to Prevent Blindiness, New York, NY. The authors would like to acknowledge Jess Behrens MS, Kathryn Jackson MS, and Theresa Walunas PhD for their assistance with data acquisition and analysis. Publisher Copyright: {\textcopyright} 2023 Taylor & Francis Group, LLC.",

year = "2023",

doi = "10.1080/09286586.2023.2168015",

language = "English (US)",

volume = "30",

pages = "453--461",

journal = "Ophthalmic Epidemiology",

issn = "0928-6586",

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TY - JOUR

T1 - Health Care Disparities in Diabetes and Diabetic Retinopathy

AU - Bryar, Paul J.

AU - Wang, Andrew

AU - Eichinger, Sarah E.

AU - Agron, Samantha

AU - Langguth, Anne

AU - Mbagwu, Michael

AU - French, Dustin D.

N1 - Funding Information: This work was supported by the National Institutes of Health [1R21EY024050-01A]. “Understanding Diabetic Eye Disease in the Underserved Using Health Data Exchange”.Supported by an unrestricted grant from Research to Prevent Blindiness, New York, NY. The authors would like to acknowledge Jess Behrens MS, Kathryn Jackson MS, and Theresa Walunas PhD for their assistance with data acquisition and analysis. Publisher Copyright: © 2023 Taylor & Francis Group, LLC.

PY - 2023

Y1 - 2023

N2 - Purpose: To investigate prevalence of diabetes (DM), diabetic retinopathy (DR), and areas with highest rates of undetected DR. To quantify and map locations of disparities as they relate to poverty and minority populations. Methods: Retrospective cohort study from large regional health data repository (HealthLNK). Geographic Information System (GIS) analysis mapped rates of DM and DR in Chicago area ZIP Codes. Results: Of 1,086,921 adults who met the inclusion criteria, 143,790 with DM were identified. ZIP Codes with higher poverty rates were correlated with higher prevalence of DM and DR (Pearson’s correlation coefficient 0.614, p < .05, 0.333, p < .05). Poverty was negatively correlated with likelihood of DR diagnosis (−0.638, p < .05). Relative risks of DM and DR were calculated in each ZIP Code and compared to actual rates. 36 high-risk ZIP Codes had both high-risk of DM and low DR detection. In high-risk ZIP Codes 85.4% of households self-identified as ethnic minority and 33.0% were below the Federal Poverty Level (FPL). Both percentages were significantly higher than the Chicago average of 50.5% minority and 19.9% below FPL (p < .05). 67 ideal ZIP Codes had both low risk of DM and high DR detection. In ideal ZIP Codes 32.6% of households self-identified as minority, and 10.2% were below the FPL (p < .05). Conclusions: A health care disparity exists with regards to DM and DR. High-risk ZIP Codes are associated with higher poverty and higher minority population, and they are highly concentrated in just 17% of the ZIP codes in the Chicago area.

AB - Purpose: To investigate prevalence of diabetes (DM), diabetic retinopathy (DR), and areas with highest rates of undetected DR. To quantify and map locations of disparities as they relate to poverty and minority populations. Methods: Retrospective cohort study from large regional health data repository (HealthLNK). Geographic Information System (GIS) analysis mapped rates of DM and DR in Chicago area ZIP Codes. Results: Of 1,086,921 adults who met the inclusion criteria, 143,790 with DM were identified. ZIP Codes with higher poverty rates were correlated with higher prevalence of DM and DR (Pearson’s correlation coefficient 0.614, p < .05, 0.333, p < .05). Poverty was negatively correlated with likelihood of DR diagnosis (−0.638, p < .05). Relative risks of DM and DR were calculated in each ZIP Code and compared to actual rates. 36 high-risk ZIP Codes had both high-risk of DM and low DR detection. In high-risk ZIP Codes 85.4% of households self-identified as ethnic minority and 33.0% were below the Federal Poverty Level (FPL). Both percentages were significantly higher than the Chicago average of 50.5% minority and 19.9% below FPL (p < .05). 67 ideal ZIP Codes had both low risk of DM and high DR detection. In ideal ZIP Codes 32.6% of households self-identified as minority, and 10.2% were below the FPL (p < .05). Conclusions: A health care disparity exists with regards to DM and DR. High-risk ZIP Codes are associated with higher poverty and higher minority population, and they are highly concentrated in just 17% of the ZIP codes in the Chicago area.

KW - Health care disparity

KW - diabetes

KW - diabetic eye disease

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DO - 10.1080/09286586.2023.2168015

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ER -

Health Care Disparities in Diabetes and Diabetic Retinopathy

Abstract

Funding

Keywords

ASJC Scopus subject areas

UN SDGs

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