Does low socioeconomic status affect use of nutritional services by pre‐diabetes patients?
- 27 March 2009
- journal article
- Published by Emerald in International Journal of Health Care Quality Assurance
- Vol. 22 (2), 157-167
- https://doi.org/10.1108/09526860910944647
Abstract
Purpose – This paper's aim is to identify whether community-level socioeconomic status (SES) predicts: screening test for pre-diabetes; actual diagnosis of pre-diabetes; or nutritional counseling. Design/methodology/approach – This is an analysis of 1,348,124 insured adults receiving medical care from Maccabi Healthcare Services (MHS) in 107 MHS clinics throughout Israel. The research population comprised 79 percent of the MHS members over 18 years of age in 2004-2006. Area level socioeconomic data were drawn from the Israel Central Bureau of Statistics SES index for every geographical area and each MHS clinic in the study was coded from: -1.03 to 2.73 (-1.03 indicating low SES and 2.73+ high SES) according to the SES index for the location. The fasting glucose laboratory test was used for analysis. Pre-diabetes diagnosis was based on a fasting glucose above 100?mg/dl. Nutritional counseling was defined by dietitian visits in the claims database. Findings – The percentage of insured individuals who underwent blood glucose testing during the study increased with age from 67 percent at ages 18-45 to 92 percent for age 65 and over. The percentage of individuals diagnosed with pre-diabetes also increased with age, rising from 4 percent in the younger group to 14 percent in those aged 46-65 and to 14-16 percent of 65 and older. The percentage of individuals with pre-diabetes who visited a dietitian was 16-27 percent for those under 65 and 14-17 percent for those over 65 (males and females, respectively). Individuals living in lower socioeconomic areas were less likely to have blood tests. Among tested patients, the prevalence of pre-diabetes was higher in areas of lower SES and their dietitian visits were less frequent. Practical implications – In lower SES index areas, there is a need for better identification and treatment of patients. Originality/value – The paper shows that a proactive approach is needed both to detect pre-diabetes and to encourage patients to receive nutritional treatment.Keywords
This publication has 25 references indexed in Scilit:
- Do nutrition knowledge and beliefs modify the association of socio-economic factors and diet quality among US adults?Preventive Medicine, 2007
- Neighborhood deprivation and cardiovascular disease risk factors: Protective and harmful effectsScandinavian Journal of Social Medicine, 2006
- Prevalence of obesity in IsraelObesity Reviews, 2005
- The National Healthcare Quality and Disparities ReportsMedical Care, 2005
- Gender, body mass index and socio-demographic variables associated with knowledge about type 2 diabetes mellitus among 13 293 Mexican studentsActa Diabetologica, 2005
- Socio-economic status of the patient and doctor–patient communication: does it make a difference?Patient Education and Counseling, 2005
- The relationships of social participation and community ratings to health and health behaviors in areas with high and low population densitySocial Science & Medicine, 2004
- Psychosocial and socioeconomic factors associated with glycated hemoglobin in nondiabetic middle-aged men and women.Health Psychology, 2003
- The black report and beyond what are the issues?Social Science & Medicine, 1997
- Social class mortality differentials: artefact, selection or life circumstances?Journal of Epidemiology and Community Health, 1985